Chronic kidney disease (CKD) happens when your kidneys become damaged and cannot filter blood properly. Doctors divide the progression of the disease into five stages.
Stage 1 is the earliest form of CKD, when your kidneys are still working well. Stage 5 is the last stage, when your kidneys stop working altogether.
Could I Have Chronic Kidney Disease and Not Know It?
Yes, if you are in the early stages of CKD. Symptoms usually do not appear until CKD reaches an advanced stage.
Unfortunately, kidney disease is common. An estimated 15% of American adults are living with CKD, according to the Centers for Disease Control and Prevention (CDC). CKD is the ninth-leading cause of death in the United States.
Diabetes and high blood pressure are the leading causes of CKD, but obesity and a family history of CKD are also risk factors.
What Happens When You Have Chronic Kidney Disease?
Healthy kidneys remove wastes, toxins, and extra fluids from your body. The kidneys also help control blood pressure, produce red blood cells, and regulate blood chemicals.
CKD occurs if the kidneys become damaged. Extra fluids, toxins, and wastes stay in the body instead of passing out of the body in urine.
CKD is not reversible, but lifestyle changes can slow down the progression of the disease. Maintaining a healthy weight, exercising regularly, and controlling high blood pressure and diabetes can also help.
What Are the Five Stages of Kidney Disease?
Doctors will use blood and urine tests to figure out what stage your disease is in.
One important blood test is the estimated glomerular filtration rate (eGFR). It shows how well the kidneys are filtering the blood. Doctors use eGFR numbers to indicate the stages of CKD.
The stages of kidney disease are:
Stage 1 — eGFR is 90 or higher
Most people at this stage do not notice any symptoms of CKD. Your kidneys work nearly as well as normal. But blood or urine tests may show early signs of kidney problems.
Stage 2— eGFR is between 60 and 89
The damage to your kidneys is still mild in Stage 2, and you may not notice any symptoms. A urine test may reveal some protein in your urine, a sign that your kidneys are not working as well as they could. You may have swelling in your hands or feet, and frequent urinary tract infections.
Stage 3A — eGFR is 45 to 59 for three months or more
Your kidneys have moderate damage, and you may start to notice signs of CKD at this stage. Your kidneys are not functioning properly, and toxins can accumulate in your body. You have mild to moderate loss of kidney function.
Symptoms may start to appear, and you may experience the symptoms mentioned below in CKD stage 3B section.
You have mild to moderate loss of kidney function, and may have the following symptoms:
- Dry, itchy skin.
- Feeling weak
Stage 3B — eGFR is 30 to 44 for three months or more
You have moderate to severe loss of kidney function. While you cannot reverse kidney damage, you may be able to slow CKD in stage three with treatment and lifestyle changes. Your disease may not progress to stage four or five. You may experience the following symptoms :
- Dry, itchy skin.
- Feeling weak and tired.
- Foamy urine.
- Frequent urination.
- Swelling in your hands and feet.
Stage 4 — eGFR is between 15 and 29
This is the last stage before kidney failure. Wastes and toxins build up in your blood and may contribute to other health problems, like bone and heart disease.
In addition to the symptoms you felt in stage three, you may:
- Feel nauseous.
- Have periods of vomiting.
- Lack of appetite/hunger.
- Notice more swelling in your arms or legs.
- Urinate frequently.
- Weight loss without trying to lose weight.
A nephrologist (kidney doctor) can treat stage four CKD with medicines that help manage your symptoms. They will be able to tell when your kidneys are close to failure and discuss treatment options.
Stage 5 — eGFR is less than 15
At this stage, your kidneys are no longer working or are very close to failing.
In addition to the symptoms you felt in stages three and four, you may have:
- Changes in your skin color.
- Headaches.
- Little or no urine.
- Muscle cramps.
- Pain in your lower back.
- Shortness of breath.
- Breath smells bad (fishy or urine-like).
- Trouble concentrating.
There is no cure for kidney failure, but you have two treatment options to help you live:
- Dialysis — A treatment where a machine does the work of your kidneys. You can have dialysis at a treatment center or at home.
- Kidney transplant — You may be able to have surgery to receive a kidney from a deceased or living donor.
Always check with your doctor if you develop new symptoms or have questions about your kidney disease.
What Should I Know About the Stages of Kidney Failure?
Recognizing the stages of kidney failure is key to proactive care.
This understanding allows your health care providers to take timely action to:
- Manage your symptoms.
- Plan your treatments, such as dialysis or transplant.
- Prevent complications like anemia and bone loss.
- Slow disease progression.
- Work with palliative care to improve your well-being during and after treatment.
Editor's Note: This article was originally published on , and was last reviewed on .