Overview: Five Stages of Kidney Failure
Chronic kidney disease (CKD) is a gradual process of kidney damage that can be controlled but not cured. There are five stages of CKD that progress from normal kidney function in the first stage, mild kidney damage in the second stage, and progressively worse damage in the final stages to the point of total kidney failure.
The Renal Association points out there are no outright symptoms of kidney damage--the only way to find out is through a blood test or urinalysis. If you have immediate family members who suffer from CKD or you are taking medications that could affect your kidneys, please take extra precautions to ensure your kidneys stay healthy.
How Are the Stages of Kidney Failure Tested?
Chronic kidney failure can be difficult to differentiate from acute kidney failure at first, but if a person has a Glomular Filtration Rate (GFR) < 60 mL/min/1.73 m2 for more than three months, they are considered CKD patients.
One way of testing for CKD includes taking a 24-hour urine sample to test the amount of protein and creatinine in the urine, along with a blood creatinine sample that is measured alongside the urine sample. This "creatinine clearance" basically measures how much creatinine is filtered from the blood into the urine, and if it is outside of the normal range then there is certain proof the kidneys are damaged.
If it is early enough in the process, it is hard to tell whether the kidneys have acute damage, which can be reversible, or chronic damage. If a blood test shows abnormalities, the kidneys are generally monitored for a span of time (at least three months) to assess the situation and see if it is CKD.
During the initial three stages of kidney failure it is possible to control and minimize the damage through strict diet and medications.
Stage 1 CKD: In the first stage the kidneys are generally undamaged, but have slightly diminished function. This stage is the most difficult to diagnose CKD, so even if caught, it can be treated as acute kidney failure (which is reversible) until proven otherwise. GFR is high to moderately high (>90 mL/min/1.73 m2).
Stage 2 CKD: Slightly more kidney damage at this stage, but this, too, would only be detectable by a blood or urinalysis, or through X-rays or other imaging scans. GFR begins to drop at this stage (60-89 mL/min/1.73 m2).
Stage 3 CKD: At this point, CKD should be established, because GFR drops to (30-59 mL/min/1.73 m2), and a patient should be experiencing discomfort and illness due to malfunctioning kidneys.
In the last two stages of CKD the kidneys have significant enough damage to where they cannot be controlled with medication alone.
Stage 4 CKD: By this stage, GFR is severely reduced (15-29 mL/min/1.73 m2) and you should be preparing for alternative renal therapies like a transplant or dialysis.
Stage 5 CKD: This is end stage renal failure, and at this point the options are dialysis or a kidney transplant.
What Happens Next?
Although Stage 5 CKD basically means your kidneys no longer function, you still have the options of dialysis or a transplant.
This stage can be held off for a significant length of time by following a strict diet (limited in protein), and assiduously following a program set by your physician to ensure your body can function as normally as possible. This program may include hormone therapy to replace the hormones your kidneys produce, and other therapies to reduce chemicals like phosphates in your system. The goal of kidney therapy is to stave off Stage 5 CKD. With the current technological and medical advancements, you can live a long and healthy life by managing your CKD.