Individuals diagnosed with chronic kidney disease (CKD) often have many questions about their condition and wonder what to expect. CKD, also known as chronic kidney failure, causes a gradual loss of kidney function over time.
The disease progresses through five stages based on the results of the glomerular filtration rate (eGFR) test — a medical test used to estimate the functioning of the kidneys — and how well the kidneys function to remove waste and extra fluid from the blood. A higher eGFR number indicates better kidney function, while a lower number suggests poor function.
Knowing which stage of disease a person is in is crucial for effective management. Health care providers can use eGFR to monitor changes in kidney function, personalize treatment and effectively manage kidney health.
Stage 1 — eGFR of 90 or greater — and Stage 2 — eGFR between 60 and 89
During the early stages of CKD, the kidneys still function well, and people may not experience any symptoms. However, it is important to control blood sugar and blood pressure levels and follow a healthy, balanced diet. Individuals in this stage may also need to take medication to minimize the amount of protein in their urine.
Stage 3 — eGFR between 30 and 59
As CKD progresses, the kidneys start to lose their ability to filter waste from a person’s blood. People with CKD may experience swelling in their feet and ankles, itchy skin or fatigue at this stage.
To manage the condition, a person with CKD must work closely with their doctor to check their blood pressure, blood sugar and cholesterol levels. They may also need to limit the intake of sodium, protein and phosphorus. With proper treatment and a healthy lifestyle, many people in stage 3 of CKD can avoid progressing to stage 4.
Stage 4 — eGFR between 15 and 29
By this stage, kidney function has significantly decreased. People in this stage of CKD will likely experience symptoms such as nausea, vomiting and poor appetite. Some may also experience anemia, which can cause fatigue and weakness.
Anyone in this stage must keep their blood pressure under control, monitor their fluid intake, and continue to restrict their sodium, protein and phosphorus intake. A doctor may also start discussing dialysis and kidney transplant options.
Stage 5 — eGFR less than 15
In the final stage of chronic kidney disease (CKD), the kidneys stop functioning properly, and a person will require either dialysis or a kidney transplant. Dialysis involves filtering the blood through a machine that removes waste and excess fluid. If a transplant is necessary, the patient will receive a new kidney from a deceased or living donor. The decision between dialysis and transplant depends on several factors and requires careful consideration.
“Managing CKD requires a carefully planned diet that balances nutrient restrictions with a variety of fruits and vegetables,” says Christine Brenner, Operations and Outreach lead for the Sharp HealthCare Kidney and Pancreas Transplant Program. “It's important to consult a doctor or dietitian to create a customized meal plan. Early detection and management can help slow the progression of the disease and improve quality of life.”
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