What is Chronic Kidney Disease? Know the Stages, Symptoms & Care Tips

Overview: The 5 Stages of Chronic Kidney Disease

Chronic Kidney Disease (CKD) doesn’t happen overnight. It progresses through five defined stages, from mild kidney impairment to complete kidney failure. Each stage reflects how efficiently your kidneys filter waste through a measure called Glomerular Filtration Rate (GFR). Understanding these stages is key to early intervention and long-term kidney health.

Stage 1 CKD – Mild Kidney Damage with Normal GFR

• GFR: ≥90 mL/min

• Symptoms: Often no symptoms; possible signs include protein in the urine (proteinuria) or physical kidney damage detected via tests.

At Stage 1, your kidneys are still functioning at a normal level, but there are early signs of damage—such as inflammation or protein leakage into the urine. Most people do not notice any symptoms at this stage, which is why it’s often diagnosed incidentally during routine health screenings. Detecting CKD at this stage offers the best opportunity to slow or even halt its progression.

What You Should Do:

• Keep blood pressure and blood sugar under control

• Quit smoking and avoid excessive alcohol

• Begin following a kidney-friendly, low-sodium diet

• Get regular kidney function tests to monitor for changes

Stage 2 CKD – Mild Kidney Damage with Slight Decrease in GFR

• GFR: 60–89 mL/min

• Symptoms: Still minimal or absent; possible signs include mild fatigue, swelling, or increased blood pressure.

Stage 2 CKD involves a mild decline in kidney function, though the kidneys still manage to perform their job effectively. This stage may be marked by subtle issues such as slightly elevated blood pressure, fluid retention, or fatigue. Like Stage 1, it’s often only detected through blood or urine tests.

What You Should Do:

• Follow a low-protein, low-sodium diet to reduce kidney workload

• Stay physically active and maintain a healthy weight

• Schedule regular check-ups with a nephrologist

• Begin lifestyle changes to support long-term kidney function

Stage 3 CKD – Moderate Kidney Damage

• GFR: 30–59 mL/min

• Symptoms: Fatigue, fluid retention, muscle cramps, changes in urination, and lower back pain

Stage 3 is when kidney function becomes noticeably impaired and symptoms start to manifest more clearly. Waste products begin to accumulate in the bloodstream (uremia), causing fatigue and discomfort. This is often the turning point where proactive treatment becomes critical.

What You Should Do:

• Work with a renal dietitian to manage potassium, phosphorus, and sodium levels

• Get tested and treated for anemia and bone mineral disorders

• Maintain strict blood pressure and glucose control

• Attend frequent medical appointments for kidney function monitoring

Stage 4 CKD – Severe Kidney Damage

• GFR: 15–29 mL/min

• Symptoms: Nausea, poor appetite, sleep disturbances, numbness, and difficulty concentrating

At this stage, kidney function is severely compromised, and the body begins to experience systemic effects. Toxins accumulate rapidly, and complications such as anemia, metabolic bone disease, and nerve issues may worsen. Medical preparation for kidney replacement therapy becomes necessary.

What You Should Do:

• Start discussing dialysis or kidney transplant options with your doctor

• Follow a strict kidney-specific diet with medical supervision

• Undergo frequent lab tests to track kidney function and complications

• Take medications as prescribed to manage symptoms and slow progression

Stage 5 CKD – Kidney Failure (End-Stage Renal Disease)

• GFR: <15 mL/min

• Symptoms: Severe fatigue, itching, swelling, confusion, and little or no urine output

Stage 5 is also known as end-stage renal disease (ESRD), where the kidneys have lost nearly all function. At this point, waste and fluid can no longer be removed efficiently, and immediate medical treatment is essential. Without dialysis or a kidney transplant, life-threatening complications can occur.

What You Should Do:

• Choose a dialysis type (hemodialysis or peritoneal dialysis)

• Consider evaluation for a kidney transplant

• Seek psychological and emotional support for chronic illness adjustment

• Follow a comprehensive treatment plan under close medical supervision