The different stages of chronic kidney disease

A person is diagnosed with kidney disease when their kidneys no longer function properly. This could be due to a patient’s medical or genetic history (either with themselves or their family) or abnormal findings in their kidneys through blood and/or urine tests. According to the National Kidney Foundation, kidney disease becomes chronic kidney disease (CKD) when kidney function decreases over time, usually about three months, and can lead to kidney failure. Baylor College of Medicine nephrologist Dr. Samaya Anumudu, explains the five stages of CKD.

“The stages are defined by how well the kidneys filter, or the estimated glomerular filtration rate (eGFR), and/or protein levels, with stage one being the best and stage five the most severe/end stage,” Anumudu said.

• Stage 1: eGFR is at 90 or above and kidney damage (uACR/creatinine of 30 or higher) for three or more months.
  • Usually, there are no symptoms at this stage.
• Stage 2: eGFR is between 60 and 89 and kidney damage (uACR/creatinine of 30 or higher) for three or more months.
  • Usually, there are no symptoms at this stage.
• Stage 3a: eGFR is between 45 and 59.
  • Symptoms vary from none to losing weight due to a lack of appetite or changes in urination
• Stage 3b: eGFR is between 30 and 44.
  • Symptoms vary from lack of appetite, shortness of breath and/or changes in urination
• Stage 4: eGFR is between 15-29 for three months or more.
  • Symptoms vary: loss of appetite, urinating either more or less than usual, having trouble sleeping or concentrating.
• Stage 5: eGFR is less than 15 for three months or more.
  • Symptoms: loss of appetite, swelling of extremities, losing weight, not urinating or doing so less than normal.

“At stage five, we consider a patient in end-stage kidney disease, and that’s when we are preparing for options like dialysis or hopefully kidney transplantation,” Anumudu said.

Early identification of kidney disease is important. Naturally, kidney disease can progress over time, but whether this happens quickly or slowly depends on several factors. Anumudu says that there is some data on diet and protein modifications that can help delay the progression of CKD and hopefully avoid further failure and need for dialysis or transplantation.

“In general, if you’re in the earlier stages of kidney disease [stage one or two], you should have your blood and urine tested annually,” Anumudu said. “At stage three and above, if a patient is stable, I recommend seeing a nephrologist at least every three to four months. Certainly, in stages four and five, you should be seeing a nephrologist a lot more often.”

Learn more about kidney disease and the stages of CKD here and here.

By Taylor Barnes