Understanding the 5 stages of Chronic Kidney Disease

We do not have to stress out or even define what CKD is because we have discussed it in this blog in several articles and we already know what it is all about.

Instead today we are going to take a deep look at the 5 stages of Chronic Kidney Disease that were developed or designed by the National Kidney Foundation (NKF) in order to understand better Kidney diseases and to give doctors  some sort of guideline that will help them identify the evolution of the kidney disease and know how to give the patient the best care possible for each stage.

FIVE_5 stages of Chronic Kidney Disease

Image courtesy of electricnude at Flickr.com

Let’s take a look at those 5 stages.

Stage 1 and 2:

Somebody that is in stage 1 or 2 of CKD has a small kidney damage and his or her glomerular filtration rate (GFR) is normal or a bit higher than 90 ml/min. in this stage, symptoms are not common and the kidneys are still working normally. If the person is to find out he or she is on stage 1 CKD it is because the person was being tested for other things and the results came out with certain amount of creatinine levels or they discovered blood or protein in the urine or there was an imaging test and the results said there was a kidney damage.

For people that are in this stage the treatment only focuses on a healthy diet including whole grains, fresh fruits and vegetables, no fats or low fat diets, control the intake of sugar and sodium, have a good weight and exercise very regularly, take vitamins recommended by doctors and definitively stop smoking and having bad habits for the body.

When it comes to stage 2, the description is just the same with the disease having no symptoms and the kidney working at a very good level. The only difference here is that the kidney already has a mild damage and it is getting a bit late to discover it or to treat it and the glomerular filtration rate is around 60-89 ml/min.

Stage 3:

Here the person has already a moderate kidney damage. This stage has two parts which are called A and B. in stage 3A the glomerular filtration rate is 45-59 mL/min, and in stage 3B the glomerular filtration rate is 30-44 mL/min.  Here the disease is already noticeable and patients start to feel the symptoms. A condition called uremia appears and secondary complications such as high blood pressure, anemia and bone disease start to appear as well.

The symptoms for this stage are the feeling of being tired all the time, high retention of fluids, extremities start to swell and the patient starts feeling that his or her breath is just not enough, urine changes color to a more reddish, brownish color or it even contains blood which will make it red, lower back pain, problems with sleep and muscle cramps.

In this stage, the kidney is working at a 50% performance and the idea is to help the patient keep their kidneys working as long as possible.

In this stage, a very controlled diet and medications are essential to make the kidney live longer. When it comes to medications ( the diet is very important even since stage 1) in this stage they become essential to control glucose levels and have a very good blood pressure in order to maintain the kidney working for as long as possible. The medications doctors prescribe in this stage are ACE (angiotensin converting enzyme) inhibitors and ARBs (angiotensin receptor blockers).

Stage 4:

Here the patient has a real problem that needs to be tackled as soon as possible and with the correct treatment. Their glomerular filtration rate is 15-30 ml/min. and treatments are now very viable options. Unfortunately, a patient with stage 4 CKD will have to get a kidney transplant in the near future. In this stage conditions like anemia, uremia, bone disease, high blood pressure, heart complications and cardiovascular diseases start to become present.

The symptoms in this stage are fatigue, hard kidney pain in the lower back, sleeping problems, nausea, vomiting, a  metallic taste in their mouth, bad breath, loss of appetite due to the flavor in their mouth, difficulty in concentrating and numbness or tingling in the toes or fingers.

In this stage, there are 3 different types of treatments which are Hemodialysis, Peritoneal dialysis and, Kidney transplant

Stage 5:

Unfortunately, at this stage, the person has no options and it is a terminal disease called end-stage renal disease (ESRD) that has a glomerular filtration rate of 15 ml/min or less. In this stage, the kidneys no longer work and don’t have the ability to do anything at all. In this stage dialysis or a kidney transplant will be needed to survive.  

It is very important to understand these five stages so patients and doctors can find out about the disease in the early stages and give patients the option of having a very good quality of life.

Be sure to also read this post about how to choose the right treatment in case of renal failure?