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Stages of Kidney Disease

5 Stages of Chronic Kidney Disease 

What do the stages of chronic kidney disease 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 (1-3), your kidneys are still able to filter waste out of your blood. In the later stages (4-5), you kidneys must work harder to filter your blood and may stop working all together. 

Stage 1 of CKD (eGFR of 90 or greater)

What is eGFR? 

Stands for estimated glomerular filtration rate (eGFR) test measures how well your kidneys filter waste and toxins from your blood. It's a key tool in understanding your kidney function and can help determine if you have kidney disease.

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Stage 1 CKD means you have 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 damager, such as protein in your urine. 

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Stage 2 of CKD (eGFR between 60 and 89)

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.

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Your kidneys are mostly still able to work as they should to filter your blood which is why you may not notice any effects on your health. While the damage to your kidneys may not be reversible, there is a lot you can do to slow down the damage to your kidneys. 

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Signs and symptoms of Stage 2 CKD include: 

  • Protein in your urine 

  • High blood pressure

  • Swelling in your hands or feet

  • Urinary tract infections 

  • Blood in your urine (also called hematuria) 

  • Kidney damage that shows up in an ultrasound, CT scan, MRI or kidney biopsy

 

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Know the connection between high blood pressure and kidney disease 

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High blood pressure (also called hypertension) is the second most common cause of kidney failure, also called end-stage renal disease (ESRD) or end-stage kidney disease (ESKD). About one in four people with kidney failure have it because of high blood pressure. 

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High blood pressure affects 68 million people, or 1 in 3 Americans. 

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Proteinuria 

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Protein in Urine (Proteinuria) causes, symptoms, test and treatments

Protein in your urine is a sign that your kidneys may be damaged.

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Protein is normally found in your blood. The main protein in your blood is called albumin. 

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Proteins have many important jobs in your body. They help build your bones and muscles, prevent infection and control the amount of fluid in your blood.

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Healthy kidneys remove extra fluid and waste from your blood and transform it into urine. Healthy kidneys do not remove proteins and other important nutrients, which pass through and return to your blood. But when your kidneys are damaged, they may let this protein leak into your urine. 

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Causes of long-lasting protein in the urine 

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Health problems that may cause long-lasting high levels of protein in the urine include: 

  • Kidney disease

  • nephrotic syndrome

  • risk factors that give you a higher chance of having kidney disease, such as 

    • diabetes ​

    • high blood pressure 

    • family history of kidney disease 

  • Pregnancy 

  • Preeclampsia (high blood pressure that happens during pregnancy)

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Causes of short-term protein in the urine 

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Heal problems that may cause a short-term high level of protein in the urine include

  • Dehydration (not having enough water in your body)

  • High stress 

  • Being in very cold temperatures 

  • Fever 

  • High-intensity physical activity 

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What are the symptoms of protein in the urine? 

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When you kidneys have only mild damage and you have only small levels of protein in your urine, you will not notice any symptoms 

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When your kidneys have more severe damage and you have high levels of protein in your urine, you may stay to notice symptoms such as:

  • Foamy, frothy or bubbly urine 

  • Swelling in your hands, feet, belly, or face 

  • Urinating more often

  • Feeling sick to your stomach or throwing up

  • Muscle cramps at night 

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How will I know if I have protein in my urine?

The name of the urine test that measures the level of albumin in your urine is called the urine albumin-to-creatinine ratio (UACR). A UACR compares the level of albumin to the level of creatinine (a waste product in your blood that comes from your muscles) A normal UACR is less than 30mg/g. If your UACR is 30 mg/g or higher, it can be a sign of kidney disease. 

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How do doctors treat protein in the urine

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If you have diabetes, your doctor will create a treatment plan to keep it under control and slow down damage to your kidneys. They may recommend that you:

  • Check your blood sugar often

  • Take certain medications 

  • Follow a diabetes-friendly eating plan

  • Be active most days of the week

If you have high blood pressure, your doctor may prescribe a medicine to help lower your blood pressure and slow down damage to your kidneys. The types of medicine are:

  • Angiotensin-converting enzyme (ACE) inhibitors, which are a group of medicine that lower blood pressure. They widen your blood vessels, help your kidneys get rid of extra water an lower the hormones that raise blood pressure 

  • Angiotensin receptor blockers (ARBS), which are a group of medicines that lower blood pressure. They widen your blood vessels. 

If you do not have diabetes or high blood pressure, your doctor may still prescribe an ACE inhibitor or an ARB to slow down damage to your kidneys.

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