When it comes to kidney health, knowledge is power. Understanding your health metrics—or “knowing your numbers”—is a vital first step in identifying and managing chronic kidney disease (CKD). Chronic kidney disease progresses in five stages, each defined by the kidneys’ ability to filter waste and maintain essential body functions. Regular monitoring of key metrics like estimated glomerular filtration rate (eGFR), blood pressure, and blood sugar is essential for early detection and better outcomes. The earlier CKD is identified, the more opportunity there is to slow its progression and protect your overall health.
The Five Stages of Chronic Kidney Disease
CKD severity is classified into five stages, ranging from mild kidney impairment in Stage 1 to complete kidney failure in Stage 5. Each stage has distinct characteristics, and tracking your numbers plays a crucial role in navigating them. Let’s break it down step by step.
Stage 1: Mild Kidney Damage (eGFR ≥ 90)
- What It Means: At this stage, your kidneys are still functioning normally, but there are early signs of structural damage. This might include protein or blood in the urine or signs of a hereditary kidney condition
- Key Numbers to Watch:
- eGFR of 90 or higher
- Blood pressure levels below 130/80 mm Hg, as high blood pressure can speed up kidney damage
- Blood sugar levels for those with diabetes (HbA1c under 6.5%) to protect kidney health
- Action Plan: Early intervention makes a significant difference here. Work with your doctor to address any underlying health conditions, such as diabetes or high blood pressure. Lifestyle changes, including a kidney-friendly diet, regular exercise, and avoiding smoking, are vital for reducing further damage.
Stage 2: Mild Decline in Kidney Function (eGFR 60–89)
- What It Means: The kidneys are functioning slightly less efficiently, but symptoms are rarely noticeable. People with Stage 2 CKD often remain asymptomatic, making regular health check-ups critical.
- Key Numbers to Watch:
- eGFR of 60–89
- Maintain blood pressure and blood sugar within target ranges
- Action Plan: Continue to focus on managing risk factors. If high blood pressure or diabetes is present, ensure these conditions are well-controlled. Your doctor may recommend dietary changes, such as lowering sodium intake and limiting processed foods. Keep monitoring your eGFR regularly to detect any changes over time.
Stage 3A: Moderate CKD (eGFR 45–59)
- What It Means: At Stage 3A, kidney damage is present but still in the earlier phase of moderate CKD. Symptoms may not yet be noticeable, but some individuals might experience mild fatigue or slight swelling in the extremities. Early diagnosis at this stage is crucial to slow progression.
- Key Numbers to Watch:
- eGFR of 45–59
- Blood pressure below 130/80 mm Hg to avoid further kidney damage
- Check for protein in your urine (proteinuria), which can indicate kidney stress
- Action Plan: Your nephrologist will focus on monitoring kidney function and slowing disease progression. They will help you address early complications such as slight fluid retention or rising blood pressure. Nutrition counseling is also important at this stage to manage protein intake, sodium levels, and other key nutrients to support kidney health.
Stage 3B: Moderate CKD (eGFR 30–44)
- What It Means: At Stage 3B, kidney damage is more advanced, and symptoms are more likely to appear. Fatigue, swelling in the hands or feet, and changes in urination patterns may become evident. Stage 3B often signals a critical point where tighter management is needed to prevent further decline.
- Key Numbers to Watch:
- eGFR of 30–44
- Blood pressure below 130/80 mm Hg, as uncontrolled hypertension can quickly worsen kidney function
- Monitor for protein in your urine (proteinuria), an important indicator of kidney stress
- Action Plan: Your nephrologist will focus on closely monitoring kidney function and managing complications such as high blood pressure, anemia, or bone health issues. In addition to medical treatment, working with a dietitian becomes crucial to adjust your diet and limit sodium, phosphorus, and protein intake while maintaining proper nutrition.
Stage 4: Severe CKD (eGFR 15–29)
- What It Means: With significantly reduced kidney function, symptoms like severe fatigue, nausea, or shortness of breath may become more apparent. Stage 4 is a critical period for preparing for the future, including identifying potential treatment options like dialysis or transplant.
- Key Numbers to Watch:
- eGFR of 15–29
- Blood pressure targets remain crucial—below 130/80 mm Hg
- Monitor electrolyte levels, as imbalances become more common
- Action Plan: Your nephrologist will play a key role at this stage, helping you manage kidney-related complications such as fluid retention, acidosis, or high potassium levels. Alongside medical treatment, nutrition counseling becomes essential to maintain a healthy balance of vitamins and minerals.
Stage 5: Kidney Failure (eGFR < 15)
- What It Means: Also known as end-stage renal disease (ESRD), this stage signifies that the kidneys can no longer function well enough to sustain life. Dialysis or a kidney transplant becomes necessary for survival.
- Key Numbers to Watch:
- eGFR below 15
- Closely monitor weight, blood pressure, and symptoms like fluid overload
- Routine lab tests to manage dialysis or pre-transplant health
- Action Plan: Patients at Stage 5 need a well-coordinated care team, including nephrologists, dialysis technicians, and transplant specialists. While the transition can be overwhelming, advances in treatments and patient education make living with ESRD manageable for many.
The Importance of “Knowing Your Numbers”
Chronic kidney disease often progresses silently. By the time symptoms surface, significant damage might already be done. This is why tracking your numbers regularly is crucial. Key indicators like eGFR, blood pressure, and blood sugar levels offer a clear picture of your kidney health, allowing both patients and doctors to respond proactively.
- eGFR: This measures how well your kidneys filter blood. It’s the most reliable metric for determining the stage of CKD and monitoring progression.
- Blood Pressure: High blood pressure both causes and worsens kidney disease.
- Blood Sugar: For individuals with diabetes, managing blood sugar levels is critical.
Empower Yourself with Action
Knowing your numbers means taking charge of your health every day. Keep a log of your readings, adopt a balanced diet, and make lifestyle changes that support kidney function. Ask questions and stay informed about the potential impact of medications or treatments.
While CKD may feel daunting, early detection and proactive care make a world of difference. Don’t wait for symptoms to appear before acting. Start by learning your key health metrics, discussing them with your healthcare provider, and crafting a tailored plan to protect your kidneys for the long run.
By understanding them, you hold the power to shape that story toward better kidney health and a brighter future. Reach out to our team of kidney specialists for expert answers to all your questions.