Kidney Disease Stages

Chronic kidney disease (CKD) refers to all five stages of kidney damage, from very mild damage in stage 1 to complete kidney failure in stage 5. The stages of kidney disease are based on how well the kidneys can filter waste and extra fluid out of the blood. In the early stages of kidney disease, your kidneys are still able to filter out waste from your blood. In the later stages, your kidneys must work harder to get rid of waste and may stop working altogether.

Stage 1 Kidney Disease

Stage 1 CKD means you have mild kidney damage and an eGFR of 90 or greater. Most of the time, an eGFR of 90 or greater means your kidneys are healthy and working well, but you have other signs of kidney damage. Signs of kidney damage could be protein in your urine (pee) or physical damage to your kidneys.

What are the symptoms of stage 1 kidney disease?

Blood in your urine, or hematuria (though this could have other causes, as well) Higher than normal levels of proteins in your urine, or proteinuria. Visible evidence of structural damage via CT scan, MRI, ultrasound or x-ray with contrast.

What is the treatment for stage 1 kidney disease?

Typically, treatment for CKD stages 1–3 is directed at underlying conditions or CV risk factors. Common pharmacological interventions include angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs), beta-blockers, diuretics, statins and calcium channel blockers (CCBs).

Stage 2 Kidney Disease

Stage 2 CKD means you have mild kidney damage and an eGFR between 60 and 89. Most of the time, an eGFR between 60 and 89 means your kidneys are healthy and working well. But if you have Stage 2 kidney disease, this means you have other signs of kidney damage even though your eGFR is normal.

What are the symptoms of stage 2 kidney disease?

  • darker urine that may range in color between yellow, red, and orange.

  • increased or decreased urination.

  • excessive fatigue.

  • high blood pressure.

  • fluid retention (edema)

  • pain in the lower back.

  • muscle cramps at night.

  • insomnia.

What is the treatment for stage 2 kidney disease?

You may need dialysis to purify your blood. In some cases, you may need a kidney transplant. You should also talk to your doctor about controlling your blood sugar and diabetes, if you have it.

Stage 3 Kidney Disease

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, anemia (a shortage of red blood cells) and/or early bone disease.


What are the symptoms of stage 3 kidney disease?

  • dark yellow, orange, or red urine.

  • urinating more or less frequently than normal.

  • edema (fluid retention)

  • unexplained fatigue.

  • weakness and other anemic-like symptoms.

  • insomnia and other sleep issues.

  • lower back pain.

  • increased blood pressure.

What is the treatment for stage 3 kidney disease?

Stage 3 CKD doesn't require dialysis or a kidney transplant. Instead, you will be prescribed certain medications to treat underlying medical conditions that may be contributing to kidney damage.

Stage 4 Kidney Disease

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.

What are the symptoms of stage 4 kidney disease?

  • fluid retention.

  • fatigue.

  • lower back pain.

  • sleep problems.

  • increase in urination and urine that appears red or dark.

What is the treatment for stage 4 kidney disease?

Monitoring and managing. In stage 4 kidney disease, you’ll see your kidney specialist (nephrologist) often, usually once every 3 months to monitor your condition. To check kidney function, your blood will be tested for levels of:

  1. bicarbonate

  2. calcium

  3. creatinine

  4. hemoglobin

  5. phosphorus

  6. potassium

Other regular tests will include:

  • protein in the urine

  • blood pressure

  • fluid status

Your doctor will review your:

  1. cardiovascular risk

  2. immunization status

  3. current medications

  4. Slowing the progression

There’s no cure, but there are steps that can slow progression. This means monitoring and managing conditions such as:

  • anemia

  • bone disease

  • diabetes

  • edema

  • high cholesterol

  • hypertension

Stage 5 Kidney Disease

A person with stage 5 chronic kidney disease (CKD) 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 function, and eventually dialysis or a kidney transplant is needed to live.

What are the symptoms of stage 5 kidney disease?

  • Bleeding and bruising easily

  • Anemia

  • Increased blood pressure

  • High levels of urea in the body

  • Feeling noticeably fatigued or tired

  • Loss of appetite, nausea, and vomiting

  • Swelling, especially in the feet and ankles

  • Reduced mental alertness, increased trouble concentrating, or general confusion

  • Seizures

What is the treatment for stage 5 kidney disease?

  1. Dialysis

  2. Transplant

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