What are the stages of chronic kidney disease (CKD)?

Understand the 5 stages of chronic kidney disease (CKD) and how monitoring your kidney function can help slow its progression and protect your health.

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August 16, 2024

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Julie Dominguez, MD

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4 minutes

Understanding the stages of CKD

CKD is divided into five stages based on your eGFR, a measure of how well your kidneys are working. As CKD progresses, you may experience new symptoms and need additional care and support.

CKD stages at a glance

Stage

Implication

Possible signs & symptoms

Steps to take

Stages 1 & 2
— Mild CKD

• Kidney damage with normal kidney function, eGFR 90 or higher

• Mild loss of kidney function, eGFR 60-89

• High blood pressure

• Urinary tract infections

• Abnormal urine test

• Possible to have no symptoms at all

• See your primary care physician (PCP) regularly to monitor your health and eGFR rate.

• Treat symptoms and underlying health conditions (high blood pressure, diabetes) or infections.

• Take your medications as prescribed and talk to your doctor before taking new medications.

• Make healthy lifestyle changes like eating well, exercising, and quitting smoking.

Stages 3a & 3b
— Moderate CKD

• Mild to moderate loss of kidney function, eGFR 45-59

• Moderate to severe loss of kidney function, eGFR 30-44

• Symptoms from CKD stages 1 and 2

• Anemia

• Decreased appetite

• Numbness or tingling

• Decreased mental sharpness

• Feeling unwell

• Fatigue

• Dry or itchy skin

• Talk to your PCP about changes in your lab results and any symptoms you may be having.

• Get a referral to a kidney doctor (nephrologist).

• Meet with a renal dietitian to learn more about your nutritional needs and how to eat a kidney-friendly diet.

• Modify treatment as needed for any underlying conditions.

• Make healthy lifestyle changes like eating well, exercising, and quitting smoking.

Stage 4
— Severe loss of kidney function

• Severe loss of kidney function, eGFR 15-29

• Symptoms from CKD stages 1, 2, 3a, and 3b

• Anemia

• Decreased appetite and/or weight loss

• Bone disease or pain

• Abnormal blood levels of phosphorus, calcium, or vitamin D

• High potassium

• Increased acid levels in the blood

• Nausea and/or vomiting

• Swelling

• Fatigue

• Dry or itchy skin

• Trouble concentrating

• Trouble sleeping

• Learn about different treatment options and choose the one that’s best for you.

• If you’ve chosen home dialysis, begin to prepare your space and schedule a visit with an at-home nurse.

• If you’ve chosen in-center dialysis, tour a local center to get your questions answered.

• Choose an access type and take steps to get it placed.

• Start building your support network of people who can encourage you along the way.

• Make healthy lifestyle changes like eating well, exercising, and quitting smoking.

Stage 5
— Kidney failure

• Kidney failure or close to failure, eGFR less than 15

• Symptoms from CKD stages 1, 2, 3a, 3b, and 4

• Uremia

• Trouble concentrating

• Taste changes

• Fatigue

• Shortness of breath

• Nausea and/or vomiting

• Abnormal thyroid levels

• Swelling in hands, legs, and/or eyes

• Lower back pain

• Trouble sleeping

• Weight loss

• Meet regularly with your kidney doctor to monitor your progression.

• Visit your primary care doctor for any changes to your existing conditions.

• Meet with your insurance coordinator to understand your coverage options.

• Be ready to start the treatment option that best fits your lifestyle.

• Make healthy lifestyle changes like eating well, exercising, and quitting smoking.

Key takeaways

CKD is divided into five stages based on your eGFR, a measure of how well your kidneys are working.
As CKD progresses, you may experience new symptoms and need additional care and support.
Taking your medications as prescribed and making healthy lifestyle changes can help slow the progression of CKD.
Working closely with your care team can help you manage your health and create a plan that is right for you.

Looking for more support?

Your care team can help you understand your CKD stage and find ways for you to feel your best.

This serves only as a guide. Talk with your healthcare provider for more information based on your health needs.

Julie Dominguez, MD

Vice President, Medical Office, Interwell Health

Julie Dominguez, MD, is a nephrologist with extensive experience in private practice nephrology and medical education. At Interwell Health, she helps advance high-quality kidney care programs that support patients and clinicians. Dr. Dominguez earned her medical degree from the University of Texas Southwestern Medical Center, completed her Internal Medicine residency at Duke University, and completed her Nephrology fellowship at the University of California San Diego.