Chronic kidney disease stages: Symptoms and treatment

By: Emily Lunardo | Kidney Health | Friday, October 14, 2016 - 02:30 PM

chronic kidney disease stages and treatmentThe risk of chronic kidney disease (CKD) increases with age. It affects over 20 million Americans and is more common in patients who already have other conditions, especially those affecting their cardiovascular system. Diabetics, people with high blood pressure, and people with a family history of kidney failure are at the highest risk of developing CKD.

Chronic kidney disease is a condition in which the kidneys gradually lose their function. The main role of the kidneys is filtering out waste. When their function is diminished, the waste doesn’t get expelled through urine, so it accumulates in the body, leading to further health complications.

If caught early, the progression of chronic kidney disease can be slowed down, thus preventing kidney failure. CKD is commonly detected through blood testing, urine albumin, and serum creatinine.

Unfortunately, in its early stage, CKD may go undetected, because it doesn’t present many symptoms. A doctor may miss the onset of CKD if they don’t regularly check your kidney function.

Stages of chronic kidney disease

There are five main stages of chronic kidney disease, but before we explain those stages it’s important to understand how kidney function is measured. Glomerular filtration rate (GFR) is the best way to measure kidney function. GFR is calculated using results from blood creatinine test along with age, race, gender, and other factors.

The five stages of CKD are:

Stage 1: GFR is normal during this stage – a healthy reading is 90 or above – but this does not mean the kidneys are not at risk. During this stage, the treatment aims to slow the CKD progression to the other stages and to reduce the risk of cardiovascular disease.

Stage 2: GFR in this stage is between 60 to 89. Kidney function is slowly declining, and your healthcare professional will try and estimate the rate of progression. Treatment in this stage is meant to reduce the risk of CKD progression as well as the risk of other health problems.

Stage 3: GFR falls between 30 to 59. Anemia and bone problems may begin to arise at this stage. Your doctor should recommend treatments to address these concerns.

Stage 4: GFR is severely dropped down to 15 to 29. Following treatment plan is essential. Treatments require preparation, for example, making a vein in the arm larger and stronger for frequent injections or having a catheter inserted into the abdomen. Kidney transplantation may also be experienced at this stage.

Stage 5: GFR is below 15, and the kidneys can only maintain up to 10 percent of their normal functioning. A kidney transplant is required.

Stages of chronic kidney disease chart


Description GFR

What this means to you


Kidney damage is present with normal GFR

90 +

  • Cause is identified.
  • Keep healthy blood pressure and blood sugar levels.
  • Have your condition monitored regularly.


Kidney damage with mildly low GFR

60 – 89

  • Disease is estimated.
  • Control blood pressure and blood sugar.
  • Continue monitoring.


Kidney damage with moderately low GFR

30 – 59

  • Anemia and bone disease prevention is key.


Kidney damage with severely low GFR

15- 29

  • Decide on treatment if kidney failure occurs.
  • Continue treatment.


Kidney failure 15 and below
  • Start dialysis for a kidney transplant or choose palliative care.

Signs and symptoms of chronic kidney disease stages

Signs and symptoms of CKD in stages 1 and 2: No physical symptoms are present, blood work shows abnormalities, urinalysis shows abnormalities, and blood pressure may be elevated.

Signs and symptoms of CKD in stages 3 and 4: Serum creatinine may be high, tiredness and fatigue, swelling, back pain, changes in appetite, poor digestion, changes in urination including frequency, color, and amount, and blood pressure is high.

Signs and symptoms of CKD in stage 5: Anemia, easy bleeding and bruising, headache, fatigue and drowsiness, weakness, mental symptoms, nausea, vomiting, thirst, muscle cramps, muscle twitching, nocturia, numb sensation, diarrhea, itchy skin, itchy eyes, skin color changes, swelling and puffiness, difficulty breathing, high blood pressure, decreased sexual interest, changes in menstrual cycle, decreased urine output, and poor digestion.

Treatment options for chronic kidney disease

elderly with chronic kidney diseaseTo prevent chronic kidney disease, it’s important that you keep your blood pressure and blood sugar levels in check, and be aware of your risk of developing CKD – for example, you should know your family history of kidney problems.

If you are at risk for CKD, it’s important that you have your kidney function tested regularly in order to determine if any kidney damage has taken place. The earlier CKD is diagnosed the better the outcome.

Treatment often involves controlling blood pressure and blood glucose levels alongside preventing other conditions such as anemia and bone disease. The mode of treatment required depends on the stage of CKD.

Also read: Chronic kidney disease diet: Food list, recommendations, and recipes

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