Stages of Kidney Disease

Dialysis Treatment Centers

Does kidney disease develop in stages?

Chronic kidney disease (CKD) usually develops in stages as the kidneys don’t usually fail all at once. Instead, kidney disease often progresses slowly over a period of years. This is good news because if CKD is caught early, medicines and lifestyle changes may help slow its progress and keep you feeling your best for as long as possible.

Why is it important to know your stage of kidney disease?

Knowing your stage of kidney disease is important for deciding treatment. CKD has five stages, ranging from nearly normal kidney function (stage 1) to kidney failure (stage 5), which requires dialysis or kidney transplant.
Understanding your stage can help you learn how to take control and slow the progression of kidney disease. The stages of renal disease are not based on symptoms alone. Instead, they reflect how effectively the kidneys eliminate waste from the blood by using an equation that estimates kidney function, known as glomerular filtration rate (GFR).

How to determine which stage of kidney disease you have?

Glomerular filtration rate (GFR) is the best measure of kidney function. The GFR is the number used to figure out a person’s stage of kidney disease. A math formula using the person’s age, gender and their serum creatinine is used to calculate a GFR.
Determining your glomerular filtration rate GFR requires a simple blood test. A doctor will order a blood test to measure the serum creatinine level. Creatinine is a waste product that comes from muscle activity. When kidneys are working well they remove creatinine from the blood. As kidney function slows, blood levels of creatinine rise.
The below list shows the five stages of CKD and GFR for each stage:

  • Stage 1 with normal or high GFR (GFR > 90 mL/min)
  • Stage 2 Mild CKD (GFR = 60-89 mL/min)
  • Stage 3A Moderate CKD (GFR = 45-59 mL/min)
  • Stage 3B Moderate CKD (GFR = 30-44 mL/min)
  • Stage 4 Severe CKD (GFR = 15-29 mL/min)
  • Stage 5 End Stage CKD (GFR <15 mL/min)

Five stages of chronic kidney disease

A person with stage 1 chronic kidney disease (CKD) has kidney damage with a glomerular filtration rate (GFR) at a normal or high level greater than 90 ml/min. There are usually no symptoms to indicate the kidneys are damaged. Because kidneys do a good job even when they’re not functioning at 100 percent, most people will not know they have stage 1 CKD. If they do find out they are in stage 1, it’s usually because they were being tested for another condition such as diabetes or high blood pressure (the two leading causes of kidney disease). Other ways a person may discover they are in stage 1 CKD include:

  • Higher than normal levels of creatinine or urea in the blood
  • Blood or protein in the urine
  • Evidence of kidney damage in an MRI, CT scan, ultrasound or contrast X-ray
  • A family history of polycystic kidney disease (PKD)

A person with stage 2 chronic kidney disease (CKD) has kidney damage with a mild decrease in their glomerular filtration rate (GFR) of 60-89 ml/min. There are usually no symptoms to indicate the kidneys are damaged and stage 2 is usually discovered similar to stage 1 as described below:

  • Higher than normal levels of creatinine or urea in the blood
  • Blood or protein in the urine
  • Evidence of kidney damage in an MRI, CT scan, ultrasound or contrast X-ray
  • A family history of polycystic kidney disease (PKD)

A person with stage 3 chronic kidney disease (CKD) has moderate kidney damage. This stage is broken up into two: a decrease in glomerular filtration rate (GFR) for Stage 3A is 45-59 mL/min and a decrease in GFR for Stage 3B is 30-44 mL/min. As kidney function declines waste products can build up in the blood causing a condition known as uremia. In stage 3 a person is more likely to develop complications of kidney disease such as high blood pressure, anaemia (a shortage of red blood cells) and/or early bone disease. Symptoms may start to become present in stage 3 including:

  • Fatigue
  • Fluid retention, swelling (edema) of extremities and shortness of breath
  • Urination changes (foamy; dark orange, brown, tea-coloured or red if it contains blood; and urinating more or less than normal)
  • Kidney pain felt in their back
  • Sleep problems due to muscle cramps or restless legs

A person with stage 4 chronic kidney disease (CKD) has advanced kidney damage with a severe decrease in the glomerular filtration rate (GFR) to 15-30 ml/min. It is likely someone with stage 4 CKD will need dialysis or a kidney transplant in the near future. As kidney function declines, waste products build up in the blood causing a condition known as uremia. In stage 4, a person is likely to develop complications of kidney disease such as high blood pressure, anaemia (a shortage of red blood cells), bone disease, heart disease and other cardiovascular diseases. Symptoms that are experienced in stage 4 include:

  • Fatigue
  • Fluid retention, swelling (edema) of extremities and shortness of breath
  • Urination changes (foamy; dark orange, brown, tea-coloured or red if it contains blood; and urinating more or less than normal)
  • Kidney pain felt in their back
  • Sleep problems due to muscle cramps or restless legs
  • Nausea and/or vomiting
  • Taste changes such as a metallic taste in the mouth
  • Bad breath due to urea build up in the blood
  • Loss of appetite: People may not feel like eating due to nausea or other symptoms caused by waste build up in the blood
  • Difficulty in concentrating: Having trouble doing everyday things such as balancing a check book or focusing on reading the newspaper can occur
  • Nerve problems: Numbness or tingling in the toes or fingers is a symptom of CKD

A person with stage 5 chronic kidney disease has end stage renal disease (ESRD) with a glomerular filtration rate (GFR) of 15 ml/min or less. At this advanced stage of kidney disease, the kidneys have lost nearly all their ability to do their job effectively, and eventually dialysis or a kidney transplant is needed to live. Because the kidneys are no longer able to remove waste and fluids from the body, toxins build up in the blood, causing an overall ill feeling. Kidneys also have other functions they are no longer able to perform such as regulating blood pressure, producing the hormone that helps make red blood cells and activating vitamin D for healthy bones. Symptoms that can occur in stage 5 CKD include:

  • Loss of appetite
  • Nausea or vomiting
  • Headaches
  • Being tired
  • Being unable to concentrate
  • Itching
  • Making little or no urine
  • Swelling, especially around the eyes and ankles
  • Muscle cramps
  • Tingling in hands or feet
  • Changes in skin colour
  • Increased skin pigmentation

Are you at risk for kidney disease?

Kidney disease can be found through lab tests or by symptoms. High blood levels of creatinine and urea nitrogen (BUN) or high levels of protein in your urine suggest kidney disease. Diabetics should have a yearly urine test for microalbumin, small amounts of protein that don't show up on standard urine protein test.

To find a No-Cost Kidney Screening in your city click here

Do you know the causes of kidney disease and if you’re at risk? Take a 3-minute Kidney Disease Risk Quiz to see if you’re at risk for renal disease.

Take this 3-minute quiz to find out if you are at risk

If you have signs of kidney disease, you should ask for a referral to a nephrologist, a specialist in treating kidney disease. A nephrologist will perform an evaluation then suggest medications or lifestyle changes to help slow the progression of kidney disease. To contact a nephrologist at DaVita you may call us at 9740426060 or fill the form below :

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