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Stages of Chronic Kidney Disease

Topic Overview

The stages of chronic kidney disease are determined by the glomerular filtration rate. Glomerular filtration is the process by which the kidneys filter the blood, removing excess wastes and fluids. Glomerular filtration rate (GFR) is a calculation that determines how well the blood is filtered by the kidneys. It is one way to measure kidney function.

Glomerular filtration rate is usually calculated using a formula that includes a person's age, gender, race, and serum creatinine levels. A GFR under 60 mL/min/1.73 m² may indicate kidney disease. The lower the GFR 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, GFR may also be estimated with a 24-hour urine collection.

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

Stages of chronic kidney disease
Stage Description GFR What this means to you

1

Kidney damage with normal or high GFR

90 or above

  • Your doctor will try to find the cause of your kidney disease and begin treatment.
  • Keep your blood pressure below 130/80 mm Hg. If you have diabetes, control your blood sugar levels.
  • See your doctor regularly to monitor your condition.

2

Kidney damage with mildly low GFR

60–89

  • Your doctor will estimate how quickly your disease is progressing.
  • Control your blood pressure and blood sugar levels.
  • Continue regular monitoring.

3

Kidney damage with moderately low GFR

30–59

  • Your doctor will check you for complications, such as anemia and bone disease, and begin treatment if needed.
  • Continue monitoring.

4

Kidney damage with severely low GFR

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

By Healthwise Staff
Anne C. Poinier, MD - Internal Medicine
Tushar J. Vachharajani, MD, FASN, FACP - Nephrology
Last Revised August 29, 2013

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