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What are the stages of chronic kidney disease?

Kidneys are organs whose function is critical to the health of your body. Your kidneys filter your blood, removing waste and unneeded fluid. But that’s not all the kidneys do. They also produce certain hormones that help other organs function properly. And they maintain a complex balance of acid, potassium and salt in your body.

Chronic kidney disease occurs when kidneys lose their ability to work properly, sometimes due to chronic high blood pressure, uncontrolled diabetes, genetic disease or other reasons.

There are 5 stages of chronic kidney disease, as shown in the chart below.





Next Steps

Stage 1

Kidney damage with normal or elevated GFR. Kidneys are minimally damaged and still clean the blood normally.

More than 90 mL/min

Usually none

Diagnosis and treatment of CKD. Treatment of accompanying conditions. Reducing risk of CKD/slowing its progression.

Stage 2

Kidney damage with some decrease in GFR. Kidneys are not functioning normally.

60 to 89 mL/min

Usually none

Estimating and slowing progression.

Stage 3 (moderate)

Moderate decrease in GFR. Kidneys are damaged and are half way to failure.

30 to 59 mL/min

Usually none

Evaluating and treating complications and slowing progression.

Stage 4 (severe)

Severe decrease in GFR. Kidneys are near failure.

15 to 29 mL/min

There may be swelling and nausea.

Preparation for dialysis and/or transplant.

Stage 5

Kidney failure – dialysis required.

Less than 15 mL/min

There may be swelling, nausea or shortness of breath.

Dialysis is necessary. Kidney transplant possible.


Diagnosis and symptoms of CKD

Often in the early stages of kidney disease, there are few or no symptoms.

By Stage 3, an individual may develop anemia (insufficient number of red blood cells), the beginnings of bone disease or both. These conditions require treatment to improve well-being and prevent future complications.

People with Stage 4 kidney disease must begin planning for dialysis and/or a kidney transplant.

Warning signs of kidney disease

Although kidney disease often shows no symptoms in the early stages, there are some warning signs that you should be aware of. If you experience any of these, please contact your health care provider right away.

  • Nausea
  • Tiredness
  • Weight loss
  • Headaches
  • Trouble sleeping
  • Change in appetite
  • Shortness of breath
  • Pain or difficulty urinating
  • Elevated blood pressure
  • Blood or protein in the urine
  • Urine that is foamy, bloody or coffee-colored
  • Swelling or puffiness of hands, wrists, feet, thighs, abdomen or around the eyes

Tests for kidney disease

The only way to determine if you have CKD is through the use of laboratory tests. Your health care provider will perform tests of your blood or urine to see how well your kidneys are removing fluid and waste from your body.

One test to determine if kidney disease is present is called glomerular filtration rate (GFR). It is calculated by your health care practitioner after taking a sample of your blood, and it indicates how well your kidneys are functioning. If the results of your test are outside the normal range, it is likely that you will be diagnosed with kidney disease.

When you go to the doctor for a routine check-up, a urine sample is often taken and analyzed. As part of the analysis, your urine will be reviewed for indicators of kidney disease. The person analyzing the sample will be looking at the levels of red blood cells, white blood cells and protein in the urine.

Anyone with diabetes or high blood pressure should have yearly urine tests to determine if kidney disease is present. It is important to make the diagnosis when CKD is in its early stages.

Once diagnosed with kidney disease, laboratory tests are used on a regular basis to check for kidney function. A urine analysis will be used to determine the levels of BUN (blood urea nitrogen) and creatinine (chemical waste filtered by the kidneys) in your urine to see if the disease is progressing. Minerals, including calcium and phosphate, are also monitored. Often the level of parathyroid hormone will increase with kidney disease, so it is monitored to ensure that there is enough calcium and vitamin D in your body to prevent bone damage.

What if you are diagnosed with kidney disease?

There is no cure for CKD; however, if kidney disease is diagnosed in the early stages, diet changes and medications may be able to slow its progression so that you feel better, longer. In fact, with early detection, kidney disease can sometimes be halted.

If you are found to have CKD, your dietitian will provide you with an eating plan to balance the amounts of sodium, fluid and protein in your body. If the cause of your kidney disease is diabetes or high blood pressure, treating those conditions may also slow damage to your kidneys. There are many resources available today for people with CKD. You can learn more about kidney disease talking with your doctor and visiting reputable websites online.

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