The 5 stages of Chronic Kidney Disease

The 5 stages of 

Chronic Kidney Disease:

The stages are determined by your Glomerular Filtration Rate (GFR), which measures how well your kidneys filter blood. [1, 2]

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  Stage 1: 
• Kidney damage with normal or high GFR (90+ mL/min). Kidneys still function, but there are signs of damage like protein in the urine. [1, 2]
• 
• Stage 2: 
• Mild decrease in GFR (60–89 mL/min). Slight decline in function, often with few noticeable symptoms. [1, 2]
• 
• Stage 3: 
• Moderate to severe decrease.
• Stage 3a: GFR 45–59 mL/min.
• Stage 3b: GFR 30–44 mL/min.
• *Note: Users on Mayo Clinic Connect agree that Stage 3 is when symptoms like fatigue and swelling typically start becoming more noticeable. [1, 2, 3, 4, 5]
• 
• Stage 4: 
• Severe decrease in GFR (15–29 mL/min). Waste buildup causes more apparent symptoms like nausea, fatigue, and bone issues. [1, 2, 3, 4, 5]

Stage 5 (ESRD): 

• Kidney failure (GFR less than 15 mL/min). Kidneys stop working adequately to sustain life, requiring immediate medical management. [1, 2, 3]

Optimizing Function & Management

For Earlier Stages (1–4)

**The goal is to slow disease progression

and protect remaining function. [1, 2]

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  Diet: 
• Limit sodium intake to reduce blood pressure. Restrict protein to reduce the waste your kidneys must process.
• 
  
  
  Blood Sugar & Pressure: 
• Tightly control diabetes and hypertension using blood pressure medications (like ACE inhibitors or ARBs) and newer kidney-protective diabetes drugs (SGLT2 inhibitors).
• 
  
  
  Medications: 
• Monitor for anemia and bone density loss, taking supplements or binders as prescribed. [1, 2, 3, 4, 5]

End-Stage Renal Disease (ESRD):

This is Stage 5 Chronic Kidney Disease (CKD), meaning kidney function is below 15% and they can no longer filter waste effectively. To function optimally, patients must manage diets, take medications, and prepare for renal replacement therapies like dialysis or transplant. [1, 2, 3, 4]

Prepare for Stage 5 CKD by closely following a personalized, restricted diet (limiting sodium, potassium, and phosphorus), avoiding nephrotoxic medications like NSAIDs, and having a nephrologist establish an access route (fistula or graft) for hemodialysis well in advance. [1, 2, 3, 4]

Taking these precise steps is key to managing the condition and ensuring a smooth transition into necessary renal replacement therapy:

• 
  
  
  Consult a Dietitian: Work with a specialized renal dietitian to build a meal plan low in sodium, potassium, and phosphorus to prevent waste buildup and maintain caloric intake. [1, 2]

• 

  Fistula and Graft Access

  
  

Peritoneal Access

       

Establish Dialysis Access: 

Undergo a minor surgical procedure to create a vascular access (an AV fistula or graft) months before dialysis is needed to allow it to heal and mature. [1, 2, 3]

• 

  
  Evaluate Transplant Options: 
• If eligible, undergo pre-emptive transplant evaluation or get on the regional kidney waiting list—many areas allow time to accrue even before dialysis begins. [1, 2, 3, 4]
• 
• Medication Management: 
• Strictly adhere to prescribed medications, such as phosphate binders, and strictly avoid over-the-counter NSAIDs (like ibuprofen) that can further harm remaining kidney function. [1, 2, 3]
• 
  Educational Prep: 
• Attend pre-dialysis education classes, like those offered through the National Kidney Foundation, to understand your modalities (in-center hemodialysis, peritoneal dialysis, or transplant). [1, 2, 3, 4]

**Always communicate closely with your nephrology team to manage symptoms like anemia, metabolic acidosis, and fluid overload. [1, 2]

Reputable Resources

• Medical Guides: Review the Mayo Clinic Explains Kidney Disease for an overview of symptoms and tests.
• Patient Tools & Education: The American Kidney Fund Stages of Kidney Disease offers excellent breakdowns of GFR and albumin levels.
• Comprehensive Information: The National Kidney Foundation is the premier hub for understanding causes, treatment options, and navigating life on dialysis.
• Dietary Guidance: Consult the DaVita Kidney Disease Stages resource for specialized renal diet tips and meal planning. [1, 2, 3, 4, 5]

Here is where I'm at:

I have CKD and am in ESRD. I'm on dialysis 3 days a week for 3.5 hours each. My life changed drastically on April 2, 2025. I went to the hospital for pneumonia in my lung and fluid in my heart and left on dialysis for however long it takes to get a kidney transplant. 

I've had to adjust my life tremendously. I'm not gonna lie. It takes up most of my days (and some nights) with all the added doctor's visits and procedures or tests on my days off. My days on are followed by extreme fatigue, leaving me to take naps and go to bed before the sun goes down.

It's changed my food choices and fluid intake daily. I have to be more militant about what I put in my body and how much. To be honest, in some areas there are weird options. Like I need to stay away from all chocolate, but I can have gummy candy.

It's not all bad, though. I actually started getting out of the house when I was beginning to isolate myself. I've met some amazing people I probably wouldn't have otherwise.

I even started this blog and am building my own website (which covers a lot of these same issues and a ton of other stuff). I wouldn't have even thought about doing that if my awesome renal social worker hadn't pointed me to the National Kidney Registry microsites for patients looking for a living kidney donor. My site's up and running now.

I'll be on dialysis as long as I need to be, and I'll follow all the rules. I've connected with a hospital that handles tough cases like mine, and hopefully, they'll put me on their deceased kidney donation list soon so I can get things moving.

I feel like if I stay positive about life and my limitations, I'll live a better life. I gotta look forward, not back, 'cause there's nothing I can change about what's already happened. So, I need to focus on changing my present and future. I think, for the most part, I'm doing just fine.

Thanks for reading my posts. I hope, if you're struggling with this disease or the outcome, that you find your inner peace and find even a speck of my posts helpful or useful in your life. Be well!

Tina

Here's my quote for you:

"Courage isn’t having the strength to go on – it is going on when you don’t have strength." — Napoleon Bonaparte

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