Understanding the Stages of Chronic Kidney Disease: What You Need to Know
Chronic Kidney Disease (CKD) affects more than 1 in 7 adults in the United States, often progressing silently through stages without noticeable symptoms—until kidney function is severely impaired. Whether you’ve recently received a CKD diagnosis or are supporting a loved one, understanding the stages of kidney disease is key to managing the condition and slowing progression.
This in-depth guide breaks down the five stages of CKD based on eGFR levels, symptoms, and appropriate management at each phase. Our goal is to empower you with accurate, easy-to-understand information grounded in medical expertise and patient-centered care.
What Is Chronic Kidney Disease (CKD)?
Chronic Kidney Disease is the gradual loss of kidney function over time. Your kidneys are responsible for filtering waste, regulating blood pressure, producing red blood cells, and maintaining overall fluid balance.
CKD is diagnosed when there is:
A reduced estimated glomerular filtration rate (eGFR) for 3+ months
Evidence of kidney damage, such as proteinuria or structural abnormalities
How Is CKD Diagnosed?
Doctors typically use:
Blood tests to determine eGFR
Urine tests to check for protein or blood
Imaging tests like ultrasounds
Kidney biopsy in some cases
For more on how kidney disease is diagnosed, explore the National Kidney Partners diagnosis guide.
Understanding eGFR and Kidney Function
Before diving into CKD stages, it’s important to understand eGFR, or estimated glomerular filtration rate.
eGFR is a key marker of how well your kidneys filter waste.
A normal eGFR is 90 or above.
Lower eGFR levels indicate reduced kidney function.
The stages of kidney disease are defined by your eGFR and other clinical signs.
The 5 Stages of Kidney Disease (CKD Stages Explained)
Stage 1 CKD: Mild Kidney Damage with Normal Function (eGFR ≥ 90)
What It Means:
Your kidneys are still functioning well, but there may be signs of damage, such as protein in the urine or structural abnormalities.
Common Symptoms:
Usually no symptoms
Possibly high blood pressure
Early signs of proteinuria
Management Tips:
Monitor blood pressure and glucose levels
Adopt a kidney-friendly diet
Quit smoking and reduce NSAID use
Start early with kidney-friendly changes. Explore these tips for kidney care from National Kidney Partners.
Stage 2 CKD: Mild Decrease in Function (eGFR 60–89)
What It Means:
There’s a mild decline in kidney function with continuing signs of damage.
Possible Symptoms:
Increased fatigue
Slight swelling (edema)
Elevated blood pressure
Management Tips:
Continue lifestyle changes from Stage 1
Check kidney function every 6–12 months
Begin discussions with a nephrologist
Learn how to monitor your kidney health effectively at this stage.
Stage 3 CKD: Moderate Kidney Function Decline (eGFR 30–59)
This stage is broken into two sub-stages:
Stage 3a: eGFR 45–59
Stage 3b: eGFR 30–44
What It Means:
Kidneys are not filtering efficiently. You may begin to experience more noticeable symptoms.
Symptoms by Stage:
Fatigue and weakness
Swelling in hands, feet, or ankles
Foamy urine due to protein loss
Frequent nighttime urination
High blood pressure that’s hard to control
Management Tips:
Work with a nephrologist regularly
Monitor and manage anemia and bone health
Begin preparing for possible future dialysis
Explore the impact of Stage 3 CKD and why timely care matters.
Stage 4 CKD: Severe Decline in Kidney Function (eGFR 15–29)
What It Means:
Kidney function is severely reduced, and you’re at high risk for kidney failure.
Symptoms:
Persistent fatigue
Nausea or loss of appetite
Metallic taste in mouth
Swelling and fluid retention
Changes in urination patterns
Management Tips:
Work closely with your nephrologist on treatment planning
Discuss kidney replacement options: dialysis vs. transplant
Strictly follow dietary guidelines (low protein, sodium, phosphorus)
Access stage-specific care planning resources to support nutritional needs.
Stage 5 CKD: Kidney Failure or End-Stage Renal Disease (eGFR <15)
What It Means:
Your kidneys have lost most of their ability to function. At this point, dialysis or a transplant is necessary to sustain life.
Symptoms:
Vomiting and nausea
Confusion or difficulty concentrating
Muscle cramps and twitches
Severe fatigue
Itchy skin and trouble sleeping
Management Options:
Hemodialysis or peritoneal dialysis
Kidney transplant (if eligible)
Palliative care or conservative management
For support in navigating end-stage kidney treatment, consult with experienced professionals.
CKD Progression: What Factors Influence Disease Advancement?
Understanding what accelerates or slows CKD progression can help you take control.
Risk Factors for Faster CKD Progression:
Poorly controlled diabetes or hypertension
Smoking
Obesity
High protein/sodium diet
Chronic dehydration
Overuse of NSAIDs (ibuprofen, naproxen)
Slowing Progression:
Control blood pressure (goal: <130/80)
Manage blood sugar (A1C target varies)
Avoid nephrotoxic medications
Maintain a heart-healthy, kidney-friendly diet
Get actionable advice on slowing CKD progression.
Kidney Disease Stages Chart: At-a-Glance Summary
CKD Stage | eGFR Range | Kidney Function | Symptoms | Management Focus |
Stage 1 | ≥90 | Normal | None to mild | Lifestyle adjustments |
Stage 2 | 60–89 | Mild decline | Mild symptoms | Monitor & control risk |
Stage 3a | 45–59 | Moderate decline | Fatigue, swelling | Specialist care |
Stage 3b | 30–44 | Moderate decline | More symptoms | Prepare for advanced care |
Stage 4 | 15–29 | Severe decline | Nausea, appetite loss | Treatment planning |
Stage 5 | <15 | Kidney failure | Systemic symptoms | Dialysis/transplant |
How to Monitor Kidney Health Regularly
If you’ve been diagnosed with CKD, regular monitoring is essential.
Important Tests:
eGFR and Creatinine: For kidney function
Urinalysis: Checks protein and blood in urine
Blood Pressure: High BP accelerates CKD
Electrolytes & Minerals: Balance calcium, phosphorus, potassium
Stay on top of kidney health monitoring with scheduled checkups.
Mental and Emotional Health During CKD Progression
A CKD diagnosis can bring anxiety, depression, and stress. Emotional support is just as important as physical care.
Tips for Coping:
Join a support group
Work with a counselor
Practice mindfulness or relaxation techniques
Involve loved ones in your care plan
National Kidney Partners provides patient-focused support resources to help you through each stage.
Conclusion: Navigating the Stages of Kidney Disease With Confidence
Understanding the stages of kidney disease empowers you to make informed decisions about your health. From subtle signs in early stages to major lifestyle adjustments in later ones, each phase presents a chance to slow progression and maintain quality of life.
If you or a loved one has been diagnosed with CKD, don’t face it alone. Connect with the expert team at National Kidney Partners to develop a care plan tailored to your stage, lifestyle, and goals.
FAQs About the Stages of Kidney Disease
While CKD cannot usually be reversed, early stages can be managed to prevent or significantly delay progression.
It depends on your stage. Every 12 months for early stages, and more frequently (every 3–6 months) for stages 3b and above.
No. Only patients who reach stage 5 or have end-stage kidney failure require dialysis or transplant.
Yes. With lifestyle changes, medication, and regular monitoring, many people live active, fulfilling lives—especially in the early to middle stages.