Understanding the Stages of Chronic Kidney Disease (CKD)
Finding out you have Chronic Kidney Disease (CKD) often raises more questions than answers. One of the first terms you’ll hear is your “stage,” which simply describes how well your kidneys are working. While it may sound clinical, understanding your stage is incredibly empowering—it helps you make decisions earlier, manage your health more confidently, and partner more effectively with your care team.
This guide breaks down the seven key things you should know about the stages of CKD, including what GFR means, how each stage progresses, and how early action can protect your long-term kidney health.
GFR Is the Key Number Behind Every CKD Stage
Your kidney stage is based on the Glomerular Filtration Rate (GFR)—a number that measures how well your kidneys filter waste from your blood. Think of it as your kidneys’ “performance score.”
- A GFR of 90 or higher is considered normal.
- The lower the number, the more your kidney function has declined.
Your doctor uses your GFR, along with other tests, to determine your stage and customize your care plan.
Stage 1 CKD: A Quiet Beginning (GFR ≥ 90)
In Stage 1, your kidneys still work almost normally, but there are early signs of damage such as protein in the urine. Many people feel perfectly fine at this stage.
What to focus on: Managing the underlying causes—often high blood pressure or diabetes—is essential.
A helpful step: Lifestyle changes like reducing salt, eating balanced meals, and staying active can help protect your kidney function over time.
Stage 2 CKD: Mild Decline (GFR 60–89)
Kidneys in Stage 2 are functioning at 60–89% of their normal capacity. Like Stage 1, symptoms are usually minimal or nonexistent.
What to focus on: Monitoring blood pressure and blood sugar becomes even more important.
A helpful step: Staying consistent with checkups ensures any issues are caught early. Some patients also begin consulting a nephrologist at this stage to plan ahead.
Stage 3 CKD: The Middle Stage Where Complications Can Begin (GFR 30–59)
Stage 3 is divided into two parts:
- Stage 3a: GFR 45–59
- Stage 3b: GFR 30–44
At this point, kidney function is moderately to significantly reduced, and this is usually when symptoms—or related complications—appear. These may include anemia, fatigue, bone changes, or electrolyte imbalances.
What to focus on: Regular care with a nephrologist becomes essential.
A helpful step: Most patients benefit from a renal diet tailored to kidney needs, especially when monitoring sodium, potassium, and phosphorus.
Stage 4 CKD: Preparing for Future Treatment (GFR 15–29)
By Stage 4, kidney function is severely reduced. This is the time to prepare for what’s called kidney replacement therapy, which includes dialysis and kidney transplant.
What to focus on: Learning about dialysis options—hemodialysis and peritoneal dialysis—helps you make informed decisions before you need them.
A helpful step: Work with your care team to manage electrolytes, fluid levels, and medication changes to stay as stable as possible.
Stage 5 CKD: Kidney Failure (GFR < 15)
Stage 5 is also known as End-Stage Kidney Disease (ESKD). At this point, the kidneys can no longer support the body’s needs on their own.
What to focus on: Beginning dialysis or preparing for a kidney transplant becomes necessary.
A helpful step: Stay closely connected with your nephrology team and follow your treatment plan consistently. A strong support system makes this transition easier.
Early Detection Makes the Biggest Difference
CKD is progressive, but catching it early—especially in Stages 1 or 2—offers the best chance of slowing or even halting its advancement. Regular screenings are crucial, especially if you have diabetes, hypertension, a family history of kidney disease, or heart conditions.
Early awareness gives you the power to make meaningful lifestyle changes and receive tailored care before complications develop.
Final Thoughts
Understanding the stages of Chronic Kidney Disease isn’t just helpful—it’s an act of self-advocacy. When you understand your GFR, recognize your stage, and stay engaged with your care team, you gain control over your health journey.
No matter your stage, your focus should be on proactive care, steady communication with your nephrologist, and taking advantage of kidney health solutions that support a fuller, more stable life. Contact us today!
Frequently Asked Questions
CKD damage is usually permanent, but some people see improvements in their GFR when they control blood pressure, manage diabetes, lose excess weight, or follow a kidney-safe diet. While this may shift you from Stage 3b to 3a, the goal is typically to slow progression, not reverse it.
Most early-stage CKD has no obvious symptoms. When signs appear, they can be subtle—such as fatigue, swollen ankles, muscle cramps, or nighttime urination. That’s why routine blood and urine tests are essential for early detection.
Yes. Most guidelines recommend seeing a nephrologist by Stage 3b (GFR under 45). A kidney specialist can monitor complications, adjust medications, and help you plan ahead for long-term kidney health.
Progression varies widely. Some people stay in the same stage for years with good management, while others progress faster due to uncontrolled diabetes, high blood pressure, smoking, or certain medications.
Absolutely. Eating a balanced renal diet, reducing salt, managing blood sugar and blood pressure, staying active, and avoiding NSAIDs can meaningfully protect kidney function.