The stages of Chronic Kidney Disease
Whether you've been told you are at risk of developing chronic kidney disease or have already been diagnosed, you probably want to know what to expect moving forward.
Ultimately, that will depend on how early the issue is detected.
Chronic kidney disease can be progressive, meaning that its symptoms and effects can worsen over time without specific lifestyle changes and treatments. Recommended treatment options, which can preserve kidney function and slow progression, will vary based on the stage of your chronic kidney disease.
This post explores the five stages of chronic kidney disease and the signs, symptoms, and treatment recommendations associated with each one.
What are the stages of Chronic Kidney Disease?
The severity of chronic kidney disease is measured in five stages, each of which is determined based on blood tests measuring estimated glomerular filtration rates (eGFR). An eGFR blood test is a good indicator of how well your kidneys are working. It measures the creatinine in your blood, a waste product of regular muscle activity.
Because your kidneys are the filtering system for removing waste from your blood, less creatinine is removed from the blood when the kidneys aren't working well, and, as a result, your serum creatinine levels rise.
The stages of kidney disease, based on eGFR results, are as follows:
Stage 1 (mild chronic kidney disease): Normal or high eGFR result of 90 or above
Stage 2 (mild chronic kidney disease): eGFR result of 60-89
Stage 3a (mild to moderate chronic kidney disease): eGFR result of 45-59
Stage 3b (moderate to severe chronic kidney disease): eGFR result of 35-44
Stage 4 (severe chronic kidney disease): eGFR result of 15-29
Stage 5 (end-stage chronic kidney disease): eGFR result of less than 15
Although kidney disease is not always progressive, kidney function can worsen at each stage. Therefore, depending on the stage, your kidney doctor or nephrologist will recommend specific steps to help slow development.
Here's a closer look at the stages of kidney disease.
Stage 1 and Stage 2 kidney disease
Someone with stage 1 or stage 2 kidney disease won't likely experience any symptoms indicating kidney damage because our kidneys work well even when not functioning optimally. As a result, a person with stage 1 or stage 2 chronic kidney disease may not even be aware of it. Usually, they find out while being screened for some other condition, like hypertension or diabetes, which are both leading causes of chronic kidney disease.
Stage 1 and Stage 2 kidney disease symptoms
Other indicators of stage 1 and stage 2 kidney disease include:
increased levels of urea or creatinine in their blood;
protein or blood in their urine;
signs or kidney damage discovered through a CT scan, MRI, ultrasound, etc.;
a family history of PKD (polycystic kidney disease).
Stage 1 and Stage 2 kidney disease treatment
Someone with stage 1 kidney disease should be regularly tested and monitored for progression.
The best way to slow progression is through healthy lifestyle changes, including:
maintaining a healthy diet and exercise routine;
maintaining healthy blood pressure;
controlling blood sugar levels;
regular doctor visits with eGFR testing;
take all related medications as prescribed and;
quitting smoking.
Stage 3 kidney disease
Someone with stage 3 kidney disease is going to fall into two categories based on their eGFR results:
Stage 3a: eGFR result of 45-59
Stage 3b: eGFR result of 35-44
Stage 3a kidney disease indicates mild to moderate kidney damage, while stage 3b kidney disease suggests moderate to severe damage.
Patients may experience stage 3 kidney disease symptoms as kidney function declines.
Stage 3 kidney disease symptoms
Symptoms of stage 3 kidney disease include:
fatigue
hypertension
changes in urination (including color and frequency)
back pain
swelling in the legs, hands, or feet
muscle cramping
restless leg syndrome
bone or mineral disorders
Stage 3 kidney disease treatment
If you have been diagnosed with stage 3 kidney disease, you should be working with a nephrologist. A nephrologist is a doctor specializing in the treatment of chronic kidney disease.
Your nephrologist will perform examinations and lab testing to gather information regarding your condition and help develop an appropriate course of treatment, with the overall goal of keeping your kidneys working for as long as possible.
When you suffer from stage 3 kidney disease, your nephrologist will likely refer you to a dietitian since a healthy diet is integral to slowing the progression of chronic kidney disease and promoting overall health.
A dietitian will work with you to develop an individualized meal plan for your unique needs.
Because many people with stage 3 kidney disease suffer from hypertension or diabetes, they must control their blood pressure and glucose levels to preserve kidney function. Certain medications can help slow chronic kidney disease progression in those with either or both conditions.
Be sure to discuss medication options with your doctor and, when prescribed, take them as directed.
People with stage 3 kidney disease should also be smoke-free and exercise appropriately.
Stage 4 kidney disease
When diagnosed with stage 4 kidney disease, a patient will suffer from advanced kidney damage and will likely need dialysis or a kidney transplant soon. In addition, anyone with stage 4 kidney disease will likely develop complications, including anemia, hypertension, bone disease, and cardiovascular disease.
Stage 4 kidney disease symptoms
Symptoms of stage 4 kidney disease include:
anemia (low red blood cell count)
bone or mineral disorders
high blood pressure
itchy or dry skin
muscle cramping
nausea
decreased appetite
reduced calcium, vitamin D, and phosphorus levels
shortness of breath
swelling in the legs, hands, or feet
difficulty sleeping
weakness
fatigue
urinary symptoms (including low urine output)
vomiting
Stage 4 kidney disease treatment
Someone with stage 4 kidney disease should be working with a nephrologist and dietitian.
If you have stage 4 kidney disease, you will likely be meeting with your care providers every three months, as they regularly test you to determine your level of kidney function and monitor other health conditions.
At this stage, your nephrologist will likely prepare you for kidney dialysis or a transplant.
According to the American Kidney Fund, more than 92,000 people on the national transplant waiting list are waiting for a kidney.
Choices will include:
Hemodialysis: Hemodialysis occurs at a treatment center or home, with a care partner's assistance. This treatment consists of a machine that removes a small amount of your blood and runs it through a filtration system to remove toxins your kidneys can no longer filter on their own. The system then returns the filtered blood to your body.
Peritoneal dialysis (PD): This is a convenient, needle-free treatment that may be performed anywhere without the assistance of a care partner.
Kidney transplant: A kidney transplant is the preferred stage 4 kidney disease treatment. It doesn't require the same restrictions associated with hemodialysis or PD.
Stage 5 kidney disease
For someone with stage 5 kidney disease, also known as end-stage kidney disease, their kidneys have either stopped working entirely or are very close to doing so. Individuals with stage 5 kidney disease will need continued dialysis or a kidney transplant to survive.
Managing Chronic Kidney Disease
Early detection is still the best defense against the progression of chronic kidney disease.
Although there is no cure for chronic kidney disease, it is possible to slow or even stop its progression. In many cases, proper treatment and healthy lifestyle changes will keep you and your kidneys healthier, longer.
If you believe you are at risk of kidney damage or experiencing symptoms of chronic kidney disease, talk to your doctor about your kidney function. If your kidney function is impaired, consult a nephrologist to begin treatment.
If you have been diagnosed with kidney disease, the Reset Kidney Health team can help. We know from experience that early treatment for kidney disease saves lives. With Reset, you can easily schedule appointments with our world-class kidney specialists to get the exceptional treatment you deserve - from the comfort of your home. We are currently accepting new patients. Book an appointment with one of our specialists today to see how our team can help you.
