The 5 Stages of Kidney Disease, Explained

doctor checking for the 5 stages of kidney disease
If you are suffering from chronic kidney disease (CKD), you probably know that there are five unique stages of this condition. These range from a mild loss of kidney function to total kidney failure. Not everyone will progress to the final and most serious stage. Many people will only experience moderate symptoms which can be mitigated, and lifestyle changes can often prevent progression to further stages when CKD is detected early. Here’s a basic overview of the five stages of kidney disease.

How Are Kidney Disease Stages Measured?

Kidney disease progresses at different rates for different people, and it can take between two and five years to pass between different stages. Kidney disease stages are measured by using a blood test to check the estimated glomerular filtration rate (eGFR). This shows the amount of blood that is getting filtered through the kidneys every 60 seconds. As kidney function decreases, GFR drops, so a lower GFR indicates a more advanced stage of CKD.

Stage 1

During stages 1 and 2, individuals rarely show physical symptoms. Therefore, many people with CKD in stages 1 and 2 go undiagnosed. During stage 1, you will have an eGFR of 90 or greater. A eGFR of 90 indicates that your kidneys are working well, but there are minor signs of kidney damage. You can slow down the progression of the disease by eating a healthy diet or working to stay active. 

Stage 2 

In stage 2, there will typically be an eGFR of between 60 and 89. Again, your kidneys will still be relatively healthy and working effectively. However, if you get tested for kidney disease in stage 2, the test may reveal signs of kidney damage. These signs may include low levels of protein in your urine. When detected at stage 2, CKD can still often be slowed through lifestyle changes that minimize symptoms and damage.

Stage 3

Your eGFR at Stage 3 will be between 30 and 59, indicating some damage to your kidneys. A stage 3 eGFR reading shows that your kidneys are not working at a sustainable rate of effectiveness. Stage 3 CKD can be further split into two stages: 3a and 3b. Stage 3a is specifically divided into an eGFR of between 45 and 59, while 3b indicates an eGFR of between 30 and 44. Other health complications that often develop at this stage include high blood pressure and anemia. At this stage of kidney disease, you will need to consult with a nephrologist and a renal dietician to ensure you’re making the appropriate changes needed to slow the progression of CKD.

Stage 4

By the time you reach stage 4 kidney disease, you have an eGFR that is between 15 and 29. This means that the kidneys are severely damaged. This late stage of kidney disease should be taken very seriously, as it is the last stage before kidney failure. Stage 4 kidney damage is serious, and patients will typically have many of the same physical symptoms as in stage 3. Waste levels will continue to rise in the body, potentially leading to bone disease. At stage 4, you need to regularly meet with a nephrologist and a dietitian to constantly assess the development of your CKD and to start preparing for kidney failure by deciding on treatment options.

Stage 5

When you reach stage 5, your eGFR drops below 15, and you will either be very close to kidney failure or already experiencing it. You could have trouble breathing and sleeping, and you might also find that you have a loss of appetite. You could also suffer from muscle cramps and itchingall common symptoms of advanced kidney disease. At this stage, the only treatment options for survival are to start dialysis or to receive a kidney transplant. That’s why it’s important to begin discussing treatments before stage 5 begins, so that you can have a safe option designated before your condition becomes an emergency. We hope this helps you understand the different stages of kidney disease and why early detection and treatment is so important. Remember, making changes to your lifestyle early can help you reduce the progression of this disease and avoid later, more undesirable stages.