The Stages of Chronic Kidney Disease (CKD)

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The 5 Stages of Chronic Kidney Disease (CKD)

​The kidneys have a variety of responsibilities including regulating bodily hydration, filtering waste out of the blood stream and producing hormones. So as you can imagine, if the kidneys fail to do their job, serious health complications will arise if left untreated. In fact, without dialysis treatment or an organ transplantation, kidney disease has a 100% fatality rate. There are 5 stages of kidney disease, identified by glomerular filtration rate (GFR), which is the measurement of how much blood is being filtered and cleaned by the kidneys in milliliters per minute. A lower GFR indicates lower volumes of blood are being cleaned, signaling kidney trouble. It's important to know each stage of CKD, how they impact the body and what you can do about it.

Stage 1: Minimal Function Loss (GFR 90 - 120)
The first stage of kidney failure is very minor. It's categorized by the kidneys starting to lose partial function, although no symptoms will show. It will only be detectable by blood test, so it's important to get regular checkups and request that your doctor do blood work. If your doctor does inform you that you are in the first stage, here's what you can do to minimize the risk of it progressing:

• Better manage and treat existing health conditions such as diabetes, hypertension, blood pressure, etc.
• Quit smoking
• Exercise -- a minimum of a 30-minute walk every 3 or 4 days. (If you have a dog, this shouldn't be a problem!)
• Eat better -- integrate more natural fibers into your diet with plenty of fruits and veggies. Cut out unnecessary junk food and ensure you're drinking enough water.

Stage 2: Mild - Moderate Loss of Function (GFR 60 - 89)
Again, symptoms generally won't show up until the later stages of kidney disease, but your doctor can determine if you're at this stage via blood test. If you happen to find yourself in stage 2, don't panic. This is still an early stage in the progression of CKD and it's possible to manage with the same recommendations as step 1, but you may want to additionally talk to your doctor about taking over-the-counter medication and learn everything you can about kidney disease and possible treatments.

Stage 3: Moderate - Severe Function Loss
This stage is actually broken up into two different subsets: 3a and 3b. Stage 3a is characterized by a GFR between 45-59 mL/minute while 3b is between 30-44 mL/minute. Stage 3 is where CKD starts to manifest itself through symptoms, including:

• High blood pressure
• Anemia
• Fatigue
• Kidney pain in back
• Fluid retention and swelling of the extremities
• Changes in urination frequency

Stage 3 is when things start to get really serious. It's around this time that you'll need to see a nephrologist in order to receive individualized treatment and lifestyle recommendations, including consulting a dietician. While each patient is unique in their circumstance, here are some broader expectations when it comes to diet:

• Eating high-quality proteins
• Balancing potassium intake
• Lowering sodium intake for patients with high blood pressure
• Limiting carbs and foods with high levels of phosphorus

Stage 4: Severe Loss of Function (GFR 16 - 29)
Stage 4 of CKD indicates that it is time to see a nephrologist, as you'll need dialysis or transplantation in the near future. You can expect to see a doctor every very frequently, at least once every few months, where frequent blood tests will be done. Symptoms will become more apparent as:

• You will have trouble concentrating on simple tasks such as reading and writing
• You experience shortness of breath
• Loss of appetite
• Fluid retention causes swelling of the extremities
• Nerve issues cause sudden numbness in fingertips and toes
• Things begin to taste more metallic and you experience chronic bad breath
• Urination occurs frequently and the urine is foamy or darker colored

Diet plays a major role in all stages of kidney failure. You can read a more comprehensive article on it here.

​Stage 5: End Stage Renal Disease (GFR 15 or less)
The final stage of CKD is referred to as kidney failure or end stage renal disease. It's when the kidneys have ceased to function completely and a transplantation or dialysis are needed immediately in order to live. As toxins begin to infect your blood, you will feel an overall sense of illness in addition to the many symptoms outlined above.
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End stage renal disease is no joke. Your kidneys are responsible for a myriad of bodily regulations, so treating it is imperative if you intend to live much longer. Much of the treatment will involve dialysis or transplantation in addition to drastic lifestyle changes, dietary improvements and medication. CKD is best caught early and can even be reversible if caught soon enough. So if you find that you're at risk of chronic kidney disease, schedule a consultation with a kidney specialist today.

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