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Chronic kidney disease (CKD) refers to all 5 stages of kidney damage, from very mild damage in Stage 1 to complete kidney failure in Stage 5. The stages of kidney disease are based on how well the kidneys can do their job – to filter waste and extra fluid out of the blood. In the early stages of kidney disease, your kidneys are still able to filter out waste from the blood. In the later stages, your kidneys have to work harder to get rid of waste, and may stop working altogether.

The eGFR is a blood test that measures how well the kidneys filter waste from the blood. The stages of kidney disease are based on the eGFR number.

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Stage 1 CKD

Stage 1 kidney disease means kidney damage and an eGFR greater than 90.

In Stage 1 kidney disease there is mild kidney damage, and usually no symptoms. If you have Stage 1 kidney disease, it is important to talk to your doctor about how to prevent your kidney damage from getting worse.

Most of the time an eGFR greater than 90 means the kidneys are healthy and working well. If you have Stage 1 kidney disease, this means you have other signs of kidney damage even though your eGFR is normal. Signs of kidney damage could be protein in your urine or physical damage to the kidneys.

Below are ways to slow kidney damage in Stage 1 kidney disease:

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Stage 2 CKD

Stage 2 kidney disease means kidney damage and an eGFR between 60 and 89.

In Stage 2 kidney disease there is mild kidney damage, and usually no symptoms. If you have Stage 2 kidney disease, it is important to talk to your doctor about how to prevent your kidney damage from getting worse.

Most of the time an eGFR between 60 and 89 means the kidneys are healthy and working well. If you have Stage 2 kidney disease, this means you have other signs of kidney damage even though your eGFR is normal. Signs of kidney damage could be protein in your urine or physical damage to the kidneys.

Below are ways to slow kidney damage in Stage 2 kidney disease:

•    Control your blood sugar if you have diabetes.
•    Keep a healthy blood pressure.
•    Eat a healthy diet.
•    Do not smoke or use tobacco.
•    Exercise 30 minutes a day, 5 days a week.
•    Keep a healthy weight.
•    Ask your doctor if there are medicines you can take to protect your kidneys.
•    Make an appointment to see a nephrologist, even if you already have a general doctor.

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Stage 3 CKD

Stage 3 kidney disease is an eGFR between 30 and 59.

Stage 3 kidney disease means the kidneys are moderately damaged and are not working as well as they should. Stage 3 kidney disease is separated into two stages; Stage 3a and Stage 3b. Stage 3a is an eGFR between 45 and 59. Stage 3b is an eGFR between 30 and 44.

Many people with Stage 3 kidney disease do not have any symptoms. But if there are symptoms, some of the more common ones are:

  • Swelling in the hands and feet
  • Back pain
  • Urinating more or less than normal

By Stage 3 kidney disease, you are more likely to have health complications as a result of waste building up in your body. Common complications from kidney disease are high blood pressure, anemia, and bone disease.

To keep your kidney disease from getting worse, follow the same steps for living a healthy lifestyle as in Stages 1 and 2. There are other things you can do in Stage 3 to keep your kidney disease from getting worse:

  • Visit a nephrologist to make a treatment plan that is right for you. Your nephrologist will tell you how often you will need to have your kidneys checked.
  • Meet with a dietitian, who will help you follow a diet that will keep you healthy.
  • If you have diabetes or high blood pressure, ask your doctor about special kinds of blood pressure medicines called ACE inhibitors and ARBs. Sometimes these medicines can help keep kidney disease from getting worse.

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Stage 4 CKD

Stage 4 kidney disease is an eGFR between 15 and 30.

Stage 4 kidney disease means your kidneys are moderately or severely damaged and are not working nearly as well as they should. Stage 4 kidney disease should be taken very seriously. It is the last stage of kidney disease before kidney failure.

By Stage 4 kidney disease, it becomes more common to have symptoms. Some of the more common symptoms are:

  • Swelling in the hands and feet
  • Back pain
  • Urinating more or less than normal

By Stage 4 kidney disease, you will likely have other health complications as a result of waste building up in your body. Common complications from kidney disease are high blood pressure, anemia, and bone disease.

To keep kidney disease from getting worse at this stage, there are steps that must be taken:

  • Have regular appointments with a nephrologist, to make a treatment plan that is best for you. Your nephrologist will tell you how often you will need to have your kidneys checked.
  • Meet with a dietitian, who will help you follow a diet that will keep you healthy.
  • If you have diabetes or high blood pressure, ask your doctor about special kinds of blood pressure medicines called ACE inhibitors and ARBs. Sometimes these medicines can help keep kidney disease from getting worse.


When you have Stage 4 kidney disease, this is the time to start talking with your nephrologist about how to prepare for kidney failure. Once your kidneys have failed, you will need to start dialysis or have a kidney transplant to live. You can start planning for dialysis or kidney transplant before you reach kidney failure.

  • Preparing for dialysis: There are several things you should consider when getting ready for dialysis. You will need to choose a type of dialysis, your vascular access type, and consider your finances and employment.
  • Preparing for transplant: If you are able to find a living kidney donor, you may not need to start dialysis at all. It is possible to have a transplant when your kidneys are getting close to failure. There are many things to consider as you prepare for transplant.

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Stage 5 CKD

Stage 5 kidney disease is an eGFR less than 15.

Stage 5 kidney disease means the kidneys are getting very close to failure or have completely failed.

Stage 5 kidney disease has severe symptoms because the kidneys have usually stopped working. If your kidneys fail, toxins and wastes build up in your blood which makes you very sick.

Some of the symptoms of kidney failure are:

  • Itching
  • Muscle cramps
  • Nausea and vomiting
  • Not feeling hungry
  • Swelling in the hands and feet
  • Back pain
  • Urinating more or less than normal
  • Trouble breathing
  • Trouble sleeping

Once your kidneys have failed, you will need to start dialysis or have a kidney transplant to live.

  • Preparing for dialysis: There are several things you should consider when getting ready for dialysis. You will need to choose a type of dialysis, your vascular access type, and consider your finances and employment.
  • Preparing for transplant: If you are able to find a living kidney donor, you may not need to start dialysis at all. It is possible to have a transplant when your kidneys are getting close to failure. There are many things to consider as you prepare for transplant.

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