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Kidney Failure Stages

Kidney Failure Stages

Chronic Kidney Disease (CKD) goes through several stages, with diminished renal function at every stage. Let us understand each of these stages in detail.
Ashwini Kulkarni Sule
Last Updated: Apr 23, 2018
Did You Know?
Every year about 3.9 million people are diagnosed with kidney disease in US alone. Of these, 50,000 eventually succumb to this disease, making it the ninth ranking cause of deaths.
Kidneys are a pair of bean shaped organs located at the back of the abdominal cavity, one on either side of the spine. The main function of the kidneys is to filter the blood and remove waste materials along with excess water. Besides, they also balance the electrolytes in the body and control the blood pressure. Normally, the capacity of kidneys to perform at an optimum efficiency starts diminishing in old age.
Kidney Failure Stages
Certain external factors like blood loss, dehydration or heart attack may force the kidneys to reduce their efficiency rapidly. This accounts for an acute renal failure. On the other hand, chronic kidney disease refers to the failure of kidney/kidneys to function properly, over the years. The severity of Chronic Kidney Disease (CKD) is determined upon the Glomerular Filtration Rate (GFR). The normal GFR rate in a healthy person is about 90mL/min or more. It goes on decreasing for every stage of kidney failure. The GFR for every stage is given in the table below.
Stage GFR Level
Normal kidney function 90 mL/min or more
Stage 1 90 mL/min or more
Stage 2 60 to 89 mL/min
Stage 3 30 to 59 mL/min
Stage 4 15 to 29 mL/min
Stage 5 Less than 15 mL/min or on dialysis
Stage 1
Although, the GFR level falls within the normal range, slight abnormalities in the kidney function are reported at this stage. These abnormalities are often an indication of an onset of a kidney disease. However, these abnormalities can only be found in a pathological examination.
Symptoms:
There are no physical symptoms as such at this stage.
Treatment:
If the disease is diagnosed at this stage, then treatment options are abundant. The individual needs to keep his blood pressure under control and also a close watch on symptoms is required. Making necessary changes to your diet under a physician's guidance can help prevent further damage to the kidneys.
Stage 2
There is a mild reduction in GFR level which points to a kidney disease. Blood/urine tests, imaging studies are required to find out more about the kidney disease. Often, a person discovers he has a kidney problem when he undergoes blood/urine tests for some other conditions.
Symptoms:
There are no physical symptoms at this stage as well, since kidneys continue to perform efficiently even when GFR is less than 90 mL/min. Blood/urine tests can indicate higher levels of creatinine in blood and presence of blood or proteins in urine.
Treatment:
One must regularly test for kidney function to know if the disease is advancing or not. Stricter dietary regulations and lifestyle changes are required to inhibit further advancement of the disease. A proper diagnosis at this stage is necessary to initiate the treatment of kidney disease.
Stage 3
There is a moderate reduction in the GFR level. Depending upon the GFR level, this stage is further divided into two sub-stages, 3A and 3B. GFR level between 45 to 60 mL/min falls under stage 3A, while stage 3B is more severe, with GFR level between 30 to 45 mL/min. A proper screening at this stage is a must to prevent permanent damage to the kidneys.
Symptoms:
It is at this stage, when physical symptoms actually appear. Some of these include:
  • Fatigue.
  • Change in color of the urine. It may become foamy if there are proteins present.
  • Water retention around eyes, legs, hands etc.
  • Sleep disorders.
Treatment:
Your doctor will most likely prescribe medications to control blood pressure as first course of action. You will be advised to undergo regular screenings and tests to keep a tab on the progression of the disease. While it is not possible to cure kidney disease at this stage, one can indeed prevent permanent damage to kidneys or at least slow down the progression of disease by improving their nutrition and lifestyle.
Stage 4
The GFR level drops to 15 to 29 mL/min which is an indication of an end stage kidney failure. Other organs in the body also start affecting due to kidney dysfunction.
Symptoms:
Apart from the symptoms mentioned in stage 3, a person may also exhibit following physical symptoms:
  • Loss of appetite.
  • Bad breath.
  • Nausea, vomiting.
  • Little urination.
  • Nerve problems such as numbing or tingling sensation in fingers.
Treatment:
Your nephrologist may discuss your treatment options at this stage, which are generally limited. Hemodialysis, peritoneal dialysis and kidney transplant are some viable treatment options at this stage. Your nephrologist may also evaluate options for creating an appropriate access for dialysis.
Stage 5
The GFR level falls so low that the kidneys almost cease to work. One by one, other organs may also start showing diminished performance.
Symptoms:
In addition to symptoms at stage 4, a patient may also experience following symptoms:
  • Loss of concentration.
  • Itching.
  • Change in skin color or pigmentation.
  • Muscle cramps.
Treatment:
The only treatment available to improve the chances of survival is permanent renal replacement therapy. The options discussed at stage 4 are implemented.
Kidneys are one of the most important functional organs in the human body. Unhealthy lifestyle can greatly affect the working of kidneys. Hence, it is imperative that you adopt a healthy lifestyle and drink lots of water to avoid going through kidney failure.
Disclaimer: This article is intended for information purpose only. Do not use the information presented herein as a substitute for medical practitioner's advice.