Chronic Kidney disease (CKD)

Chronic kidney disease (CKD) is the slow loss of kidney function over time. It can be defined as the presence of kidney damage, or a decreased level of kidney function, for a period of three months or more. The main function of the kidneys is to remove waste and excess water from the body. Usually, chronic kidney disease starts slowly and silently, and progresses over a number of years. In the early stages, there may be no symptoms as the loss of function usually takes months or years to occur. There are many causes of chronic kidney disease, but the two most common causes are diabetes and high blood pressure. Some kidney conditions are inherited while others are congenital. There are five stages of Chronic Kidney Disease, although not everyone will progress from Stage 1 to Stage 5; there are things you can do to slow or stop the damage to your kidneys. Taking medicines and making some lifestyle changes can help you manage your disease and feel better.

Chronic Kidney Disease can be divided into five stages, depending on how severe the damage is to the kidneys, or the level of kidney functioning remaining. One way to measure how well your kidneys are working is to figure out your glomerular filtration rate (GFR), which is an estimated percent of how much your kidneys can filter. The higher your GFR is, the better your kidneys are able to filter the waste and excess fluid in your body. GFR can be determined by you blood tests. The GFR is usually calculated using results from your blood creatinine, age, race, gender and other factors. Your GFR tells your doctor your stage of kidney disease and helps the doctor plan your treatment.

The stages of CKD are:

Stage 1 – Kidney damage (protein in the urine) and normal GFR (>90)
Stage 2 – Kidney damage and mild drop in GFR (60–89)
Stage 3 – Moderate drop in GFR (30–59)
Stage 4 – Severe drop in GFR (15–29)
Stage 5 – Kidney failure: dialysis or kidney transplant needed (GFR <15)

Stage	Explanation
Stages 1 and 2 CKD	People with Stage 1 CKD have kidney damage with normal or high GFR greater than 90 ml/min. They generally do not experience any symptoms of kidney damage even if the kidneys are no longer functioning at full capacity. Most people are diagnosed with Stage 1 CKD in the process of being tested for another condition such as diabetes or high blood pressure, which are the two leading causes of kidney disease.
Stage 3	A person with Stage 3 CKD has kidney damage with a moderate decrease in the GFR of 30-59 ml/min. As kidney function declines, waste products and toxins begin to build up in the blood. Once toxins reach a certain level, uremia occurs and complications of kidney disease such as high blood pressure, anemia (a shortage of red blood cells) and/or early bone disease are more likely. At this stage of kidney disease it is important for patients to be followed regularly by a kidney specialist (Nephrologist)
Stage 4	A person with Stage 4 CKD has advanced kidney damage with a severe decrease in GFR to 15-30 ml/min. It is likely someone with Stage 4 CKD will need dialysis or a kidney transplant in the near future. As kidney function declines, waste products and toxins build up in the blood causing a condition known as “uremia.” At Stage 4, complications such as high blood pressure, anemia (a shortage of red blood cells), bone disease, heart disease and other cardiovascular diseases become more likely so it is important that people at Stage 4 CKD pay careful attention to their health.
Stage 5	A person with Stage 5 CKD has end stage renal disease (ESRD) with a GFR of 15 ml/min or less. At Stage 5 kidney disease, your kidneys are no longer able to remove waste and fluids from the body effectively which leads to a build-up of toxins in the blood. Most people at Stage 5 CKD will need dialysis or a kidney transplant.