Stages of chronic kidney disease
Chronic kidney disease (CKD) is classified by five stages of increasing severity using a glomerular filtration rate (GFR) test. This test measures how many milliliters (ml) of waste products the kidneys can filter in 60 seconds.
Stage 1 - Slight kidney damage with normal or increased filtration. There are usually no symptoms of kidney damage. (GFR >90)
Stage 2 - Mild decrease in kidney function. There are usually no symptoms of kidney damage. (GFR 60 – 89)
Stage 3 - Moderate decrease in kidney function. Most people diagnosed with stage 3 kidney disease continue to manifest no related symptoms. However, some symptoms may begin appearing including fatigue due to anemia that develops at this level. Some people may experience swelling in the lower legs, hand, eye area, or shortness of breath but the majority do not develop fluid retention problems until stage 5.
Stage 4 - Severe decrease in kidney function. Despite the low kidney function level, many people diagnosed with stage 4 kidney disease will continue to manifest no symptoms. Some will develop fatigue, related to anemia. Itching (pruritis) can develop at this stage due to high phosphorus in the blood. Some are more prone to fluid retention with increased swelling in the legs. Blood work may reveal an inability to excrete adequate amounts of potassium from the blood and extra medications may be necessary to assist the process. Low vitamin D levels often require supplementation at this level. (GFR 15 – 29)
Stage 5 – During stage 5, kidney failure (or end-stage renal failure) is a total or near-total loss of kidney function. Uremic (i.e. "urine in the blood") problems usually occur at this stage. Signs include fatigue, weakness, no appetite or a "metallic" taste to food. As kidney function decreases, nausea, vomiting, confusion and difficulty concentrating are symptomatic. Additional symptoms can include itching, restless legs syndrome and numbness or tingling in the toes or fingers. Urine volume may decrease, causing swelling of the legs, eye region, or shortness of breath due to fluid build up in the lungs. Some people can continue to make adequate amounts of urine even after starting dialysis. (GFR < 15)
People diagnosed with CKD, need to have regular checkups to monitor levels of creatinine, urea nitrogen, potassium, phosphorus, parathyroid hormone, hemoglobin, and cholesterol in the blood. If blood tests show abnormal levels of any of these substances several times, doctors can prescribe related medications. Continue here to learn more about how doctors treat chronic kidney disease, including more on kidney disease diet.
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