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Stages of Chronic Kidney Disease (CKD): What They Mean for You

A man with gray hair sits thoughtfully next to a brightly colored diagram of a kidney cut in half, illustrating the five stages of chronic kidney disease (CKD) from Stage 1 (green) at the top to Stage 5 (dark red) at the bottom. The logo for Kidney MD is visible in the upper right corner.
Understanding your stage of Chronic Kidney Disease (CKD) is the first step toward proactive care. Learn what your eGFR means and how working closely with your doctor at every stage can help you protect your kidney function and health for the long term.

Chronic kidney disease (CKD) is when your kidneys gradually lose function over time. Many people don’t know they have CKD until it’s advanced — but by understanding the stages of CKD, you can take action earlier to protect your kidneys, stay healthy, and avoid complications.


How Are CKD Stages Determined?

CKD is staged mainly by two tests:


  • eGFR (estimated glomerular filtration rate): A blood test that estimates how well your kidneys filter waste. This is a simple calculation based on your serum creatinine, age and sex. 


  • Urine albumin-to-creatinine ratio (uACR): A urine test that checks for protein leakage, an early sign of kidney damage.


Doctors use both eGFR and protein in the urine to determine risk and guide treatment.


The 5 Stages of CKD

A clean, five-color infographic illustrates the cross-section of a kidney, segmented by Chronic Kidney Disease (CKD) stages. Arrows point to five colored ovals detailing each stage: Stage 1 (Green, eGFR ≥ 90), Stage 2 (Blue, eGFR 60–89), Stage 3 (Yellow/Orange, eGFR 30–59), Stage 4 (Orange/Red, eGFR 15–29), and Stage 5 (Dark Red, eGFR <15, Kidney Failure). The Kidney MD logo is in the corner.
Understanding your Chronic Kidney Disease (CKD) stage is key to effective management. This visual guide shows how your eGFR corresponds to the five stages of CKD, helping you and your doctor make proactive choices to protect your kidney health.

Stage 1 CKD


  • eGFR: ≥90 (normal kidney function)

  • Urine: Protein (albumin) may be present or there might be a structural abnormality with the kids.

  • What it means: Your kidneys work normally, but early damage may be happening.

  • What to do: Control blood pressure, manage diabetes if present, reduce salt, and check labs as recommended by your doctor.


Stage 2 CKD


  • eGFR: 60–89

  • Urine:  Protein (albumin) may be present or there might be a structural abnormality with the kids. In absence of these, you don’t have CKD by definition. 

  • What it means: Mild loss of kidney function, often without symptoms.

  • What to do: Monitor kidney labs every 6–12 months, eat a kidney-friendly diet, avoid over-the-counter painkillers (NSAIDs) unless approved.


Stage 3 CKD (3A & 3B)


  • Stage 3A eGFR: 45–59

  • Stage 3B eGFR: 30–44

  • What it means: Moderate loss of kidney function. Symptoms like fatigue, swelling, or changes in urination may begin.

  • What to do: Get labs every 3–6 months, monitor electrolytes, and check hemoglobin for anemia. Follow up regularly with your nephrologist. It’s important to understand that while we can take steps to slow down or prevent further decline, kidney function usually cannot be restored once your eGFR has been low for 3 months or more. The focus at this stage is on preserving the kidney function you have and incorporating all recommended measures to reduce the chances of needing dialysis or a transplant in the future. Please work with your nephrologist closely. 


Stage 4 CKD


  • eGFR: 15–29

  • What it means: Severe loss of kidney function. At this stage, complications such as anemia, bone disease, or changes in blood acid levels (metabolic acidosis) are more common.

  • What to do: Get labs every 1–3 months, and work closely with your nephrologist and dietitian. Together, we will focus on slowing down further loss of kidney function and preparing in case dialysis or transplant is needed in the future. The goal is to stay stable as long as possible and avoid sudden changes that might lead to hospitalization or further decline in kidney function.


Stage 5 CKD (Kidney Failure / ESRD)


  • eGFR: <15

  • What it means: The kidneys are no longer able to filter waste effectively. Symptoms may include swelling, nausea, shortness of breath, or fatigue.

  • What to do: At this stage, most patients will need dialysis or a kidney transplant to stay healthy. Your nephrology team will guide you through preparing for these options. Even in Stage 5, the focus is not just on dialysis — it’s also on maintaining quality of life, nutrition, and strength so you can stay as independent and active as possible. Not all patients with CKD stage 5 will need dialysis. Read more here.


Labs to Watch at Every Stage

  • Creatinine and eGFR – kidney function

  • Urine protein (ACR) – early kidney damage

  • Sodium, potassium - electrolytes governed by the kidney

  • Phosphorus, calcium – mineral balance

  • Serum bicarbonate – acid-base balance

  • Hemoglobin – anemia check

  • Albumin – nutrition status


FAQs About CKD Stages


❓Can CKD stages improve?

Improvement is uncommon, but in the early stages of CKD, it is possible to stabilize kidney function by controlling blood pressure, blood sugar, and making healthy lifestyle changes. Even if kidney function doesn’t “improve,” stability is a success — it means you may never need dialysis in your lifetime. Check your risk of needing dialysis here.


❓What stage of CKD is considered kidney failure?

Stage 5 CKD (eGFR <15) is kidney failure. Dialysis or transplant may be required.


❓Do all patients with CKD need dialysis?

Not immediately. Many people remain stable for months or years with careful management. Dialysis starts when symptoms or labs show it’s needed. Read in detail here.


It depends on your stage: annually in early CKD, every 3–6 months in Stage 3, monthly in Stage 5 or on dialysis. Read more here.


The Takeaway

CKD has 5 stages, from mild kidney damage to kidney failure. Knowing your stage helps you and your doctor decide how often to check labs, what diet to follow, and when to plan for dialysis or transplant.


👉 Tip: Ask your doctor for your eGFR and urine protein results at every visit — and track them over time. Early action can make a huge difference.



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