Understanding Chronic Kidney Disease (CKD)
Knowing how CKD affects your body can help you make the right choice forward in your treatment journey.
How is CKD diagnosed?
You may not notice symptoms until your CKD is quite advanced. Symptoms are often nonspecific and may vary from person to person. Because your kidneys are capable of compensating for reduced function, CKD symptoms may not show until irreversible damage has occurred.
CKD stages
A measure called the glomerular filtration rate (GFR) is used to determine your CKD stage. The GFR is calculated using a combination of inputs, including your age, gender, race and your blood’s level of creatinine—a waste product. If your GFR number is low, your kidneys are not working as well as they should be.
See below for a quick summary of each CKD stage and its associated GFR, and learn more about stage 3, stage 4 and stage 5.
Stage 1 CKD
Description: Your kidneys are damaged, but are almost able to function normally
GFR: Above 90 mL/min
What this means: Your kidneys are working at an almost normal level, but there may be blood or protein in the urine. There are no symptoms of CKD itself, but there may be symptoms of the underlying diseases causing CKD, such as diabetes or glomerulonephritis. You will have regular clinician visits to monitor your GFR and manage any other health issues that may affect your kidney functioning.
Stage 2 CKD
Description: Damage has caused a mild loss of your kidney function
GFR: 60-89 mL/min
What this means: Like in stage 1, the loss of kidney function is still mild, and usually, symptoms have not developed. However, people with diabetes are often diagnosed during CKD stage 2 and will start treatment to help slow down CKD progression. You will need to regularly visit your clinician to have your GFR monitored and manage any health problems that may affect your kidney functioning.
Stage 3 CKD
Description: Damage has caused a moderate loss of your kidney function
GFR: 30-59 mL/min
What this means: CKD stage 3 is a key stage when symptoms may first occur or kidney disease may be first diagnosed. At this stage, treatment should be undertaken to slow the progression of the disease. Many people live with stage 3 CKD, with only some progressing to the advanced stages. Regardless, undergoing regular assessment and treatment is essential to prevent the progression. You will need your clinician to test regularly for complications and should discuss treatment options with them to prepare for the case that kidney failure develops.
Learn more about chronic kidney disease stage 3 and the symptoms you may experience.
Stage 4 CKD
Description: Damage has caused a severe loss of your kidney function
GFR: 15-29 mL/min
What this means: CKD stage 4 means there is advanced kidney damage, with a high risk of progression to kidney failure. You may notice symptoms of chronic kidney disease (CKD). There should be discussions and planning for dialysis to replace kidney functions at stage 4. You should either be in treatment for your chronic kidney disease (CKD) or have discussed treatment options with you clinician to prepare for the event that kidney failure develops.
Learn more about your chronic kidney disease stage 4 and the treatment options available to you.
Stage 5 CKD
Description: Your kidneys have failed
GFR: Less than 15
What this means: CKD stage 5, also known as end-stage kidney disease, indicates kidney failure, where one will need to start dialysis. Remember that every chronic kidney disease (CKD) patient is unique. Not only your glomerular filtration rate (GFR), but also your age, physical condition, medical history and lifestyle will factor into your clinician’s treatment recommendation. The treatment choice should always be a joint decision between you and your clinician.
Address CKD risk factors
Multiple risk factors and causes can increase your chance of developing CKD. It is important to address these potential conditions so that you can reduce your risk of developing CKD.
Manage other long-term medical conditions
If you have chronic conditions that might contribute to CKD, such as diabetes or high blood pressure, it is critical that you treat them properly. Follow your doctor's recommendations, take your prescribed medications and schedule regular doctor appointments to maintain good control over your blood sugar or blood pressure.
Quit smoking
Smoking puts you at a higher risk of cardiovascular conditions, such as heart attacks and strokes, which are some of the risk factors of CKD. Quitting smoking can improve your overall well-being by lowering the risk for developing many chronic diseases.
Eat a healthy diet
Following a healthy, balanced diet can regulate your blood pressure, sugar, and cholesterol level, reducing the risk of developing CKD.
A well-balanced diet consists of:
- a variety of fruit and vegetables
- complex carbohydrates, such as whole grains and legumes
- dairy products or dairy substitutes
- foods rich in protein such as beans, fish, eggs, and meat
You should avoid foods that are high in:
- saturated/trans fat
- salt
- sugar
If you have already been diagnosed with CKD, your doctor may also advise you to make dietary adjustments that can help delay its progression, such as lowering your potassium or phosphate intake.
Avoid excessive alcohol intake
If you do decide to drink, it's important to do so in moderation.
Drinking excessive amounts of alcohol can cause your blood pressure and cholesterol levels to rise to unhealthy levels.
Adopt a more active lifestyle
Regular exercise can help lower your blood pressure and reduce the risk of CKD. It is recommended to do at least 150 minutes of moderate-intensity aerobic activity, such as cycling or rapid walking, per week. For at least 2 days a week, it is also advised to include strength exercises to build your core muscles, which are found at your pelvis, lower back, hips, and abdomen. Training these muscles allows you to have better stability and balance.
How is CKD treated?
There are various treatment options for CKD, and it is critical that you play an active role in determining which is right for you.
Each treatment option has its own benefits. Most late-stage CKD patients are treated with dialysis, as their kidneys can no longer filter blood sufficiently, but there are alternative options as well.
Prepare yourself to have an informed discussion with your clinician about which CKD treatment is best, based upon your physical, emotional and lifestyle needs. Learn about the different treatments so you and your clinician can select the most suitable option for you.
Resource: CKD basics
Learning what CKD is and how it affects your body can seem like a big challenge. Therefore, we have summarized the most important things you need to know in a simple chart. Download and print it or share it with your family or caregiver.
Resource: CKD glossary
Being diagnosed with CKD and starting on dialysis probably means that you will face a lot of words you have never encountered before. We have created a small glossary to help you learn the most essential terminology. Download and print it out so you can start to familiarize yourself with some of the words you will be hearing.
Talking to your doctor
Feeling empowered with knowledge and information can help you have a more productive partnership with your healthcare provider.