My wifes cousin is up to stage 5, she needs a kidney transplant which she's putting off, even though she has a willing donor , her brother, its that or dialysis.
She has had kidney disease for many years and it doesn't get better, I believe a low protein diet slows the progression, but at some point it's a transplant or the dialysis.
From what I understand once you start dialysis, you can no longer get a transplant.