Stages of kidney disease
- Medically reviewed by
- AKF's Medical Advisory Committee
- Last updated
- October 26, 2022
Chronic kidney disease (CKD) is divided into five stages. The stages are based on the eGFR test result and how well your kidneys work to filter waste and extra fluid out of your blood. As the stages go up, kidney disease gets worse and your kidneys work less well. At each stage, it is important to take steps to slow down the damage to your kidneys.
What do the stages of chronic kidney disease (CKD) refer to?
The five stages of CKD refer to how well your kidneys are working. Kidney disease can get worse in time. In the early stages (Stages 1–3), your kidneys are still able to filter waste out of your blood. In the later stages (Stages 4–5), your kidneys must work harder to filter your blood and may stop working altogether.
The goal at each stage of CKD is to take steps to slow down the damage to your kidneys and keep your kidneys working as long as possible.
What are the five stages of chronic kidney disease (CKD)?
Each stage is based on the eGFR number and has different symptoms and treatments.
Stage 1 of CKD
Stage 1 CKD means you have a normal eGFR of 90 or greater and mild damage to your kidneys. Your kidneys are still working well, so you may not have any symptoms. You may have other signs of kidney damage, such as protein in your urine.
Stage 2 of CKD
Stage 2 CKD means your eGFR has gone down to between 60 and 89, and you have mild damage to your kidneys. Most of the time, your kidneys are still working well, so you may not have any symptoms. You may have other signs of kidney damage, such as protein in your urine or physical damage.
Stage 3 of CKD
Stage 3 CKD means you have an eGFR between 30 and 59 and mild to moderate damage to your kidneys. Your kidneys do not work as well as they should to filter waste and extra fluid out of your blood. This waste can build up in your body and begin to cause other health problems, such as high blood pressure and bone disease. You may begin to have symptoms, such as feeling weak and tired or swelling in your hands or feet.
Stage 3 CKD is split into two substages based on your eGFR:
- Stage 3a means you have an eFGR between 45 and 59
- Stage 3b means you have an eGFR between 30 and 44
With treatment and healthy life changes, many people in Stage 3 do not move to Stage 4 or Stage 5.
Stage 4 of CKD
Stage 4 CKD means you have an eGFR between 15 and 29 and moderate to severe damage to your kidneys. Your kidneys do not work as well as they should to filter waste out of your blood. This waste can build up in your body and cause other health problems, such as high blood pressure, bone disease and heart disease. You will likely have symptoms such as swelling of your hands and feet and pain in your lower back.
This is the last stage before kidney failure. It is important to have regular visits with a nephrologist (kidney doctor) to take steps to slow kidney damage and plan ahead for possible treatments for kidney failure.
Stage 5 of CKD
Stage 5 CKD means you have an eGFR less than 15 and severe damage to your kidneys. Your kidneys are getting very close to failure or have already failed (stopped working). Because your kidneys have stopped working to filter waste out of your blood, waste products build up in your body, which can make you very sick and cause other health problems. When your kidneys fail, treatment options to survive include dialysis or a kidney transplant.
WATCH: Learn about the 5 stages of chronic kidney disease (CKD)
How can doctors tell my stage of CKD?
To find out your stage of CKD, doctors will do tests, such as:
- eGFR tests (blood tests), which is a measure of how well your kidneys are working
- Urine (pee) tests
Please note: eGFR is an estimate of how well your kidneys are working. The way eGFR is calculated will be changing. Currently the test considers your age, sex and race, among other things. A task force led by the National Kidney Foundation (NKF) and the American Society of Nephrology (ASN) is working on recommendations that may remove Black race as a factor in the eGFR calculation. The task force has been seeking the input of kidney disease experts to come up with the best way to make the eGFR test as accurate as possible. The American Kidney Fund (AKF) advised the task force to remove race from the eGFR so there is no bias in testing kidney function. This would help to make sure that every person will receive health care that is fair and of the highest quality. When the NKF-ASN task force makes its recommendations, AKF will promptly review them and then update our educational materials.