The journey through the stages of kidney disease can bring many questions and concerns. It's important to learn what changes occur in your kidneys as the disease progresses, how to manage your health, and what treatment options are available.

This information will help you and your loved ones face this challenge with confidence and hope.

What do the stages of chronic kidney disease (CKD) refer to?

CKD is broken into five stages or categories based on your eGFR value. The five stages of CKD refer to how well your kidneys are working. Kidney disease can get worse in time. In the early stages (Stages 1–3), your kidneys are still able to filter waste out of your blood. In the later stages (Stages 4–5), your kidneys must work harder to filter your blood and may stop working altogether.

The goal at each stage of CKD is to take steps to slow down the damage to your kidneys and keep your kidneys working as long as possible.

Stage 1 of CKD (eGFR of 90 or greater)

Stage 1 CKD means you have a 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 damage, such as protein in your urine, which can be detected by a uACR test.

Learn more about stage 1 chronic kidney disease (CKD)

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.

Learn more about stage 2 chronic kidney disease (CKD)

Stage 3 of CKD (eGFR between 30 and 59)

Stage 3 CKD means you have an eGFR between 30 and 59 and mild to moderate damage to your kidneys. Your kidneys do not work as well as they should to filter waste and extra fluid out of your blood. This waste can build up in your body and begin to cause other health problems, such as high blood pressure and bone disease. You may begin to have symptoms, such as feeling weak and tired or swelling in your hands or feet.

Stage 3 CKD is split into two substages based on your eGFR:

• Stage 3a means you have an eFGR between 45 and 59
• Stage 3b means you have an eGFR between 30 and 44
• With treatment and healthy life changes, many people in Stage 3 do not move to Stage 4 or Stage 5.

Learn more about stage 3 chronic kidney disease (CKD)

Stage 4 of CKD (eGFR between 15 and 29)

Stage 4 CKD means you have an eGFR between 15 and 29 and moderate to severe damage to your kidneys. Your kidneys do not work as well as they should to filter waste out of your blood. This waste can build up in your body and cause other health problems, such as high blood pressure, bone disease, and heart disease. You will likely have symptoms such as swelling of your hands and feet and pain in your lower back.

This is an important stage because it is the last stage before kidney failure. It is important to have regular visits with a nephrologist (kidney doctor) to take steps to slow kidney damage and plan ahead for possible treatments for kidney failure.

Learn more about stage 4 chronic kidney disease (CKD)

Stage 5 of CKD (eGFR less than 15)

Stage 5 CKD means you have an eGFR of less than 15 and severe damage to your kidneys. Your kidneys are getting very close to failure or have already failed (stopped working). Because your kidneys have stopped working to filter waste out of your blood, waste products build up in your body, which can make you very sick and cause other health problems. When your kidneys fail, treatment options to survive include dialysis or a kidney transplant.

Learn more about stage 5 chronic kidney disease (CKD)

Albuminuria Stages

CKD is also categorized based on albuminuria, which is measured through a urine test. This information helps you and your doctor further understand your risk for complications and if your kidney disease is getting worse, such as progressing to kidney failure. 

There are three categories of albuminuria. 

• A1: Normal to mildly increased urine protein levels (<30 mg/g or <3mg/mmol)
  This is the healthiest range, meaning your kidneys are either functioning normally or are only slightly affected. While there's some albumin in the urine, the level is very low.
• A2: Moderately increased urine protein levels (30-300 mg/g or 3-30 mg/mmol)
  This stage means there is a noticeable amount of albumin in your urine, which means your kidneys are more impacted. You and your doctor may need to discuss additional ways to manage your kidney health and prevent further damage.
• A3: Severely increased urine protein levels (>300 mg/g or >30 mg/mmol)
  In this stage, a high level of albumin is present in your urine. This means your kidneys are severely damaged, and you're at a higher risk for kidney failure or other complications like heart disease.

WATCH: Learn about the 5 stages of chronic kidney disease (CKD)