STAGES OF CHRONIC KIDNEY DISEASE (CKD)

About Chronic Kidney Disease:                                

Chronic kidney disease (CKD) is a disease whereby the kidneys have trouble removing waste products and fluid from the body. Usual causes of CKD include Diabetes Mellitus, high blood pressure and chronic glomerulonephritis. People with CKD often have no symptoms although the kidney function is severely affected.

With chronic kidney disease (CKD), the kidneys don't usually fail all at once. Instead, kidney disease often progresses slowly over a period of years. This is good news because if CKD is caught early, medicines and lifestyle changes can possibly help delay disease progression.                              

CKD Stages:                                            

To help improve the quality of care for people with kidney disease, the National Kidney Foundation created guidelines to help doctors classify different stages of kidney disease so that treatment strategies can be better tailored to their needs. Patients at each of the five stages of CKD require different tests and treatments.

National Kidney Foundation guidelines define the stages of CKD based on measured or estimated glomerular filtration rate (GFR) and corresponding decline in kidney function.                                            

The table below shows CKD and GFR for each Stage:

CKD Stages 1 & 2:

People with CKD Stage 1 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.

Other signs of CKD Stages 1 & 2:

• Higher than normal levels of creatinine or urea in the blood
• Blood or protein in the urine
• Evidence of kidney damage in an MRI, CT scan, ultrasound or contrast X-ray
• A family history of polycystic kidney disease

CKD 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.                                                                                                                      

CKD Stage 4:

A person with CKD Stage 4 has advanced kidney damage with a severe decrease in GFR to 15-30 ml/min. It is likely someone with CKD Stage 4 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 CKD 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 CKD Stage 4 pay careful attention to their health.                                                                                                                                                            

CKD Stage 5:

A person with CKD Stage 5 has End Stage Renal Disease (ESRD) with a GFR of 15 ml/min or less. At CKD 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 CKD Stage 5 will need dialysis or a kidney transplant.

Patient in CKD Stage 5 may experience symptoms such as:

• Loss of appetite
• Nausea and/or vomiting
• Headaches
• Fatigue
• Trouble concentrating
• Itching
• Little or no urine
• Swelling, especially around the eyes and ankles
• Muscle cramps
• Tingling in hands or feet
• Changes in skin color
• Increased skin pigmentation