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Chronic Kidney Disease (CKD) Stages

The kidney is a complex organ that consists of many different types of specialized cells, highly organized in a functioning unit called the nephron. Due to diseases (such as diabetes, hypertension, urinary tract infections, etc) or other risk factors (e.g. family history, older age), the nephron may fail to perform its function.

Once the damage of the kidneys starts, the process is ongoing and kidney function tends to decline, even if the initial insult has been eliminated. Although the damage cannot be repaired, there are steps you can take to slow down the progression of CKD and keep your kidneys healthier for a longer time - a balanced diet, special medication, change of lifestyle, etc.


What are the 5 stages of chronic kidney disease?

The stages of CKD are determined by how well the kidneys perform their function, i.e. filter out waste and extra fluid from the blood. The more advanced the kidney disease is, the harder it is for kidneys to get rid of these metabolic end-products which may lead to them [lead them to] stop working altogether.

This is estimated by the glomerular filtration rate (GFR), a number that is determined with a simple blood test and the amount of creatinine (a waste product) in your blood. A lower GFR signifies that a smaller amount of blood passes through the kidney filters each minute.

With this in mind, there are 5 kidney disease stages that reflect gradual adaptation in nephron loss:

  • Stage 1: Kidney damage with normal kidney function
    • GFR level: 90ml/min or higher
    • kidneys are usually healthy and working well, but there are other signs of damage like proteinuria (protein in urine) or physical damage
    • it is usually determined by abnormalities in the blood, urine tests or imaging studies
  • Stage 2: Kidney damage with mild loss of kidney function
    • GFR level: 60-89 ml/min
    • similarly to stage 1, kidneys are usually healthy and still performing well, but there are signs of damage like proteinuria (protein in urine) or physical damage
    • patient is diagnosed with CKD
  • Stage 3: Kidney damage with moderate decrease in kidney function
    • GFR level: 30-59ml/min
    • kidneys are not working as well as they should, which leads to waste building up in the body
    • at this stage, you are more likely to have health complications such as high blood pressure, anemia and bone disease
  • Stage 4: Kidney damage with severe reduction of kidney function
    • GFR level: 15-29ml/min
    • kidneys are moderately or severely damaged and are in the last stage before kidney failure
    • at this point it is time to begin preparing for dialysis and/or a kidney transplant
  • Stage 3: Kidney damage with moderate decrease in kidney function
    • GFR level below 15ml/min
    • kidneys have lost nearly all their ability to do their job effectively and are getting very close to failure or have failed completely
    • at this advanced stage, you need to start dialyzing or get a kidney transplant in order to live

If you want to learn how the GFR is estimated visit our GFR calculator page.