Kidney disease is a chronic illness that occurs when your kidneys do not function as well as they should. It is associated with aging, but some conditions also affect kidney function. The CDC estimates that up to 15% of the U.S. adult population has chronic kidney disease. Unfortunately, most people don’t realize they have it at all as it is common for no symptoms to occur until the disease reaches its advanced stages. This is why kidney disease is sometimes referred to as the “silent killer.”
Not everyone with kidney disease will develop kidney failure, which requires advanced treatment such as dialysis or a transplant. There are five stages of kidney disease, and there are also effective ways of improving your general health to avoid chronic renal problems.
Who is at Risk of Kidney Disease and Why?
Chronic kidney disease (CKD) is more common in women than men and has a higher prevalence in non-Hispanic black adults. Those with high blood pressure or diabetes are at a higher risk of developing kidney disease than healthy people. With diabetes, high sugar levels damage blood vessels, so the kidneys cannot filter out waste. Maintaining optimal blood sugars and a healthy weight lowers blood pressure and can reduce the risk of developing kidney disease.
Stages of Kidney Disease
There are five stages of kidney disease. Stages are determined by the eGFR (estimated glomerular filtration rate), which measures how well your kidneys filter waste. During the early stages (stages 1 to 3) of kidney disease, your kidneys can still filter waste effectively. However, when someone reaches the later stages of 4 or 5, their kidneys are less capable of filtering waste from the blood and may even cease functioning.
If you can maintain a healthier kidney function in stages 1-3, you may slow renal function decline over time.
Stage 1: eGFR 90 or higher
If your kidneys are at this stage, it generally means they are working well, but there is some damage. The presence of protein and/or blood cells in your urine are early findings of kidney disease that may be detected during an exam with your primary care provider. At this stage, you need to protect your health by maintaining a healthy weight, lowering your blood sugar, quitting smoking, and asking your doctor whether there is any medication that can help protect your kidneys. In addition, a referral to a kidney specialist (nephrologist) may be helpful.
Stage 2: eGFR between 60 and 89
You have mild kidney damage at this stage, although you are not likely to have any symptoms. You can continue to look after yourself by lowering your blood sugar, being active, keeping your weight under control, and maintaining a healthy diet. You need to check with your doctor about any medication that may help and see a nephrologist.
Stage 3: eGFR between 30 and 59
If you have stage 3 kidney disease, your kidneys will still function, but you may have symptoms of reduced kidney function including swollen feet or hands, anemia, and reduced urine volume. It is likely your health will be impaired at this stage. It would help if you continue to maintain a healthy lifestyle, including the actions recommended in the earlier stages.
At this stage, you should talk to your medical providers about specific categories of medications that can slow the progression of your kidney disease. A dietician will also be helpful to advise on a healthy diet. Also, a nephrologist is recommended to assist you with the management of kidney disease and other related health conditions.
Stage 4: eGFR between 15 and 29
At stage 4, you have moderate or severe damage, which means your kidneys will not be functioning as they would normally. You are likely to have symptoms such as back pain, urinating more or less frequently than usual, and swollen hands and feet. Your health will be affected as waste builds up in your body so that you will experience problems such as bone disorders, anemia, and high blood pressure. You will need to see a nephrologist regularly to support you and a dietician. You may be having a conversation with your doctor about dialysis or transplant, which you may require as your kidney disease progresses.
Stage 5: eGFR less than 15
If you have reached stage 5 kidney disease, your kidneys have either failed to work or are close to ceasing to function. When your kidneys fail, waste accumulates in your body, making you feel ill. Typically, you may experience all or some of the following: muscle pain, itching, back pain, breathlessness, nausea and vomiting, difficulty sleeping, loss of appetite, metallic taste, itching, and not passing urine. Once you get to the stage where your kidneys have failed, you will need to prepare to begin dialysis. A kidney transplant is another option, and your nephrologist will be able to help you navigate these decisions.
The PACT Kidney Center provides expert care on all aspects of kidney disease including dialysis care (in-center hemodialysis and home treatment options such as peritoneal dialysis), acute and chronic kidney disease, electrolyte disorders, and hypertension.