CKD stages

CKD stages

The stages of CKD (Chronic Kidney Disease) are mainly based on measured or estimated GFR (Glomerular Filtration Rate). There are five stages but kidney function is normal in Stage 1, and minimally reduced in Stage 2.

The KDOQI stages of kidney disease are:

Stage
GFR*
Description
Treatment stage
1
90+
Normal kidney function but urine findings or structural abnormalities or genetic trait point to kidney disease Observation, control of blood pressure. More on management of Stages 1 and 2 CKD.
2
60-89
Mildly reduced kidney function, and other findings (as for stage 1) point to kidney disease Observation, control of blood pressure and risk factors. More on management of Stages 1 and 2 CKD.
3A
3B
45-59
30-44
Moderately reduced kidney function Observation, control of blood pressure and risk factors. More on management of Stage 3 CKD.
4
15-29
Severely reduced kidney function Planning for endstage renal failure. More on management of Stages 4 and 5 CKD.
5
<15 or on dialysis
Very severe, or endstage kidney failure (sometimes call established renal failure) Treatment choices. More on management of Stages 4 and 5 CKD.

* All GFR values are normalized to an average surface area (size) of 1.73m2

Suffixes:

  • p suffix: the addition of p to a stage (e.g. 3Ap, 4p) means that there is significant proteinuria (more info)
  • T - the addition of T to a stage (e.g. 3AT) indicates that the patient has a renal transplant.
  • D - the addition of D to stage 5 CKD (e.g. 5D) indicates that the patient is on dialysis

Definition of chronic: Labelling someone as having CKD requires two samples at least 90 days apart. Historical values can be used.

Stage 2 kidney disease may be overdiagnosed by eGFR, because equations used to predict GFR (rather than real measurements) may give falsely low results in people with near-normal function.

Further information

Information about stages of CKD for patients

The stages of CKD shown in the table above are a useful aid to planning. A number of websites have further information. See general links from the foot of the CKD eGuide home page.

It is important to remember that where you are placed into CKD stage 3 or higher, it usually depends on an estimate of kidney function. These estimates are not completely precise, but usually they are reliable enough to provide useful information. More info about tests in kidney disease (EdREN). More technical info about eGFR

My stage keeps changing: It is normal for measurements of creatinine and therefore GFR to change a bit from one measurement to the next. In some patients these changes may seem large, and enough to move you from one stage to another and then back again. As long as things aren't getting progressively worse, it is the average that is important.

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