What are the five stages of kidney disease?

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 one is the earliest form of CKD, when your kidneys are still working well. Stage five is the last stage, when your kidneys stop working altogether.

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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 Center for Disease Control and Prevention (CDC).

Diabetes and high blood pressure are the main causes of CKD, but obesity and family history of CKD are also risk factors.

What Happens When You Have Chronic Kidney Disease?

Healthy kidneys remove waste, toxins, and extra fluid from your body. Kidneys also help control your blood pressure, make red blood cells, and regulate blood chemicals.

CKD occurs if the kidneys become damaged. Extra fluid, toxins, and wastes stay in the body instead of passing out of the body in urine.

CKD is not reversible, but you can slow down the progression of the disease with lifestyle changes. Maintaining a healthy weight, exercising, and keeping high blood pressure and diabetes under control can 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 (GFR). It shows how well the kidneys are filtering the blood. Doctors us GFR numbers to indicate the stages of CKD.

The stages of kidney disease are:

Stage One: GFR 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 Two: GFR is between 60-89

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 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 Three: GFR is between 30-59

Your kidneys have moderate damage, and you may start to notice signs of CKD at this stage. Your kidneys do not filter waste properly, and toxins can build up in your body. You may have the following symptoms:

  • Feeling weak and tired.
  • Swelling in your hands and feet.
  • Dry, itchy skin.
  • Frequent urination.
  • Foamy urine.

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.

Stage Four: GFR is between 15-29

This is the last stage before kidney failure. Waste 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.
  • Feel less hungry than normal.
  • Notice more swelling in your arms or legs.
  • Urinate frequently.

A kidney doctor can treat stage four CKD with medicines that help your symptoms. They will be able to tell when your kidneys are close to failure and discuss treatment options.

Stage Five: GFR is less than 15

At this stage, your kidneys do not work anymore (or are very close to failing). In addition to the symptoms you felt in stage three and four, you may have:

  • Headaches.
  • Little or no urine.
  • Muscle cramps.
  • Shortness of breath.
  • Changes in your skin color.
  • Pain in your lower back.

There is no cure for kidney failure, but you have two treatment options to help you live life. Your treatment options are:

  • Dialysis — a treatment where a machine does the work of your kidneys. You can have dialysis at a treatment center or at home.
  • A 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.

Sources

American Kidney Fund, Stages of Kidney Disease, Link

National Kidney Foundation, 10 Signs You May Have Kidney Disease, Link

National Kidney Foundation, Chronic Kidney Disease (CKD): Symptoms and Causes, Link

CDC, Chronic Kidney Disease Initiative: Prevention & Risk Management, Link

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