What are the Five Stages of Kidney Failure? A Complete Guide

Kidney disease is a complex and chronic illness. It’s typically described in stages ranging from one to five, with five being kidney failure.

The severity of an individual’s kidney disease is determined by assessing their glomerular filtration rate (GFR). GFR refers to the rate at which your kidneys filter toxins, and the five stages of kidney failure are described using GFR ranges.
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A healthy, young adult’s GFR is typically around 90-120 milliliters per minute (ml/min), but this rate gets increasingly slower as they age. Kidney disease, or an injury to the kidney, will cause their GFR to drop more rapidly than what’s typical of the natural aging process.

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Why Do Kidneys Fail?

Diabetes and high blood pressure (also known as hypertension) account for 65% of chronic kidney disease cases, according to the CDC. This is because high blood pressure weakens the blood vessels and arteries that bring blood to the kidneys, making it hard for your kidneys to function properly. As a result of these weakened blood vessels, your kidneys may be unable to filter toxins out of your blood and body.

Additionally, if you’re a smoker, you should quit. Smoking not only causes inflammation to your blood vessels, which puts you at an increased risk for heart attack or stroke, but it also puts you at a greater risk for chronic kidney disease.

Stage 1 Chronic Kidney Disease

Stage one of chronic kidney disease (CKD) is a critical phase for your kidneys. Stage 1 chronic kidney disease symptoms don’t typically show up, but it’s crucial to discover kidney disease early for treatment to be as effective as possible.

Stage 1 Chronic Kidney Disease Symptoms

During stage one of CKD, you probably won’t notice many symptoms because your kidneys can remove most toxins from your body, even if they’re not 100% functional. In fact, many people with stage 1 kidney disease have what appears to be a healthy GFR of around 90 ml/min.
However, you may still discover some symptoms through medical tests:

• Creatinine—a waste product produced by muscles—shows up in your blood
  
• Blood in your urine
  
• Renal ultrasounds or other medical imaging may reveal kidney disease during this early stage.
  

Can You Reverse Chronic Kidney Disease Stage 1?

Sadly, there’s currently no complete cure for chronic kidney disease. However, by catching it early in stage 1, you may be able to significantly slow the progression of the disease with changes to your diet and lifestyle. Consult with a kidney doctor for more information about preventing the progression of stage 1 CKD.

Stage 2 Chronic Kidney Disease

During stage two of chronic kidney disease, your kidneys are still functioning fairly well. Therefore, like stage one CKD, it’s still uncommon for symptoms to present themselves. However, if you undergo blood tests, a lower GFR ranging between 60-89 ml/min may be more noticeable.
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High blood pressure and diabetes are known as ‘silent killers,’ as about a third of individuals with these diseases don’t even know they have them. If you’re at risk for either of these diseases, be sure to consult with your doctor or a nephrologist about your risk for CKD. ​

Symptoms of Stage 2 Chronic Kidney Disease

The symptoms for stage two chronic kidney disease are effectively the same as stage one kidney disease:

• If unusually-high levels of creatinine show up in your urine, you may suffer from CKD
• Blood in your urine is always cause for concern and could be an indicator you have CKD

Stage 3 Chronic Kidney Disease

Chronic kidney disease stage three is typically described with two phases: A and B. The GFR for stage 3A ranges from 45-59 ml/min, and the GFR for stage 3B ranges from 30-44 ml/min. At this point, the disease has progressed to a point where kidney function is significantly reduced, leading to increased levels of toxins in your blood.

Stage 3 Chronic Kidney Disease Symptoms

By stage three of chronic kidney disease, symptoms will start to show. Common symptoms include:

• Pain around the kidneys and lower back
• Swelling in the arms, legs, ankles, and feet
• Difficulty sleeping
• Fatigue 
• Changes in the color of your urine

Additional health complications can come up during stage three, so it’s essential to seek medical treatment as soon as you notice any symptoms of chronic kidney disease. As we mentioned earlier, chronic kidney disease can’t be reversed, but with medical guidance from a nephrologist for altering your diet and lifestyle, you could see the disease’s progression slow.

Stage 4 Chronic Kidney Disease

Stage four of chronic kidney disease is marked by a GFR of 15-29 ml/min. At this point, your kidney function is severely limited, leading to increasingly complex health consequences if the appropriate actions aren’t taken.

Symptoms of Stage 4 Chronic Kidney Disease

Stage four of chronic kidney disease brings an increased risk for other diseases like bone disease, heart disease, anemia, and other kidney-related life-altering symptoms. If you don’t have high blood pressure, you may be at risk for developing it by stage four of kidney disease. Symptoms may include any previously mentioned in stage three, as well as:

• Nausea
• Lost appetite due to what’s often reported as a metallic taste in the mouth, or bad breath, both of which are due to the buildup of toxins within your blood
• Dark urine
• Numbness and tingling in your extremities

By stage four, you will likely need to consider beginning dialysis or preparing for a kidney transplant. Consult with a nephrologist for more information on the best choice for your health.

Stage 5 Chronic Kidney Disease

Finally, chronic kidney disease will progress to stage five. At this point, the GFR—the kidneys’ ability to filter toxins out of your blood—has been reduced to 15 ml/min or less.
Kidney function has declined so much at this point that medical interventions such as dialysis or kidney transplant are essential for surviving.

Symptoms of Stage 5 Chronic Kidney Disease

Stage five kidney chronic kidney disease symptoms are as severe as you might expect. In addition to any of the symptoms from previous stages of kidney disease, individuals in stage five of kidney disease might experience:

• Headaches and migraines
• Extreme drowsiness
• Itchy and dry skin
• Producing very little urine—which may be dark
• Swelling in the face
• Bone pain
• Weight loss
• Loss of appetite ​

End-Stage Renal Disease

Beyond stage five chronic kidney disease is end-stage renal disease (ERSD), or kidney failure. At this point, the kidneys have failed and can no longer filter toxins out of your body or send nutrients to your other organs. When a patient suffers from ESRD, they must be put on dialysis or receive a kidney transplant to survive. 

Milwaukee Nephrologists is Here to Support Your Kidney Health

For many people, chronic kidney disease can be extremely daunting. Because it’s difficult to detect early, the disease can progress by the time many individuals begin to notice symptoms. Combine that with the fact that it can’t be reversed, and you may be very concerned about your health.

The good news is that you don’t have to go through this health journey alone. Milwaukee Nephrologist’s team of kidney doctors are compassionate and experienced with all facets of kidney care and can help you develop a plan to protect your kidneys and your quality of life.

Whether you’ve been diagnosed with chronic kidney disease or want to take proactive measures for your health, our team of specialists will be able to help you find the best treatment solutions. To learn more or schedule an appointment, contact Milwaukee Nephrologists today.