What Are the Stages of Chronic Kidney Disease (CKD)?

Kidney disease doesn’t always mean undergoing hours of kidney dialysis several days each week. While those patients indeed exist, most patients with chronic kidney disease lead healthy lives with few limitations. Managing kidney disease demands attention to diet, regular medical monitoring and a commitment to living a healthy lifestyle.

How is chronic kidney disease (CKD) diagnosed? A physician orders a simple blood test that measures the estimated glomerular filtration rate (eFGR). This number takes into consideration your race, gender and age. The classification depends on the eFGR score and the level of protein found in the blood. If a patient has abnormal tests for more than three months, they have met the criteria for chronic kidney disease rather than an acute illness or injury.

Stage 1 CKD: eFGR ≥90

Stage 1 indicates an eFGR test scores 90 or more. This is normal. There may be other abnormal test results, such as blood or protein in the urine, inflammation or structural problems in the kidney. A doctor may prescribe medications to treat an infection and monitor other abnormalities.

Stage 2 CKD: eFGR 60 - 89

In this category, the level of kidney malfunction is mild. The patient also has a measure of disease or damage to the kidneys. If there is no damage or disease, the person does not have chronic kidney disease. Stage 2 is a good time to begin closely monitoring blood pressure and controlling diabetes. While the damage is irreversible, CKD can remain in Stage 2 and not progress and further.

Stage 3a CKD: eFGR 45 - 59 - Stage 3b CKD: eFGR 30-44

The two levels of stage 3 indicate moderately reduced kidney function. This stage requires no additional findings of kidney injury or disease. At these stages, a person will have problems metabolizing prescription drugs that depend on the kidney to filter them out of the body. Sometimes neurological symptoms develop. Patients in Stage 3 and higher need to ask every care provider about the level of kidney metabolism needed for each prescribed drug. Each pill or tablet may need up to 15 times the expected period to clear some drugs. It is crucial to address diabetes, high blood pressure and other health problems.

Stage 4 CKD: eFGR 15 - 29

Stage 4 indicates severe kidney disease and does not depend on a finding of kidney injury or disease. At this stage, patients and their doctors need to be especially vigilant about the complications of CKD. It takes close monitoring for fluid overload, high potassium, high phosphorus, bone disease, cardiovascular disease and metabolic acidosis with regular checkups and tests at your doctor’s office. At this stage, there may be restrictions on diet and fluid intake.

Stage 5 CKD: eFGR less than 15

Stage 5 chronic kidney disease means severely reduced kidney function. CKD 5 is also called end-stage kidney failure. It is at this stage that a physician will order regular dialysis treatments. These sessions perform the same cleaning of blood as the healthy kidneys used to accomplish. The therapy can add years to a patient’s life. At Stage 5, the patient with their doctor may wish to begin thinking about whether a kidney transplant is right for their circumstances. Both anonymous and family donors can donate a kidney to the end-stage patient.

What is Renal Failure? 

Many people may hear about renal failure. Renal failure is another term for end stage kidney disease. The kidneys are no longer functioning. This is caused by low blood pressure, urinary tract blockages, specific medications and some syndromes. Renal failure is serious. People with it are going to need to consider all medical options. 

Where to go from here

When diagnosed with kidney disease, it is important for a patient and their family to educate themselves about the disease, possible complications and what can make their disease worse. It is crucial to have regular checkups with your kidney doctor, called a nephrologist and to control conditions like high blood pressure, weight and diabetes. Proper attention can keep CKD from progressing and allow many more years of healthy living.


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