Stages of Chronic Kidney Disease

Overview

The stages of chronic kidney disease are determined mostly by the estimated glomerular filtration rate (eGFR). Glomerular filtration is the process by which the kidneys filter the blood, removing excess wastes and fluids. The eGFR is a calculation that determines how well the blood is filtered by the kidneys. It is one way to measure kidney function. Your doctor will also use a test that measures the amount of protein in your urine and the cause of your kidney disease to guide your treatment.

The eGFR is often calculated using a formula that includes a person's age, sex, and serum creatinine levels. An eGFR under 60 mL/min/1.73 m² may indicate kidney disease. The lower the eGFR number, the worse the kidney function. This number is an estimate. It may not be a good measure of kidney health in some people, such as the very young or very old, amputees, or obese people. In some cases, eGFR may also be estimated with a 24-hour urine collection.

Chronic kidney disease is defined as either kidney damage or an eGFR of less than 60 for longer than 3 months.

Stages of chronic kidney disease

Stage

Description

eGFR

What this means to you

1

Kidney damage without symptoms

90 or above

  • Your doctor will try to find the cause of your kidney disease and may begin treatment.
  • Manage other health problems, such as diabetes and high blood pressure.
  • See your doctor regularly to monitor your condition.

2

Mild decline in kidney function

60–89

  • Your doctor will estimate how quickly your disease is progressing.
  • Manage other health problems, such as diabetes and high blood pressure.
  • Continue regular monitoring.

3a

Moderate decline in kidney function

45–59

  • In stages 3a and 3b, your doctor may check for complications, such as anemia and bone disease, and begin treatment if needed.
  • Continue monitoring.

3b

Moderate to severe decline in kidney function

30-44

  • In stages 3a and 3b, your doctor may check for complications, such as anemia and bone disease, and begin treatment if needed.
  • Continue monitoring.

4

Severe decline in kidney function

15–29

  • Decide what type of treatment you want if kidney failure develops.
  • Continue treatment and monitoring.

5

Kidney failure

Below 15

  • Start dialysis, have a kidney transplant, or choose palliative care.
  • Continue to see your doctor for treatment and testing.

Credits

Current as of: September 8, 2021

Author: Healthwise Staff
Medical Review:
Anne C. Poinier MD - Internal Medicine
Kathleen Romito MD - Family Medicine
Adam Husney MD - Family Medicine
Tushar J. Vachharajani MD, FASN, FACP - Nephrology