Chronic Kidney Disease Stages: Symptoms and Treatments
The kidneys have critical functions in the body, including removing extra fluid and waste along with regulating blood pressure. When the kidneys do not function properly, it can lead to a variety of symptoms. If severe enough, kidney disease can be life-threatening. So, what are chronic kidney disease stages and how does it progress? Read on to find out.
What is Chronic Kidney Disease?
Damage to the kidneys can occur suddenly, leading to acute kidney injury or failure. It can also occur gradually. Chronic kidney disease is a loss of kidney function over time. As kidney function declines, the body cannot eliminate waste as efficiently. Fluid regulation is affected, and blood pressure may increase.
Chronic kidney disease may cause a variety of symptoms depending on the severity. Kidney disease may also progress at different rates. Early identification of the disease and proper treatment and management often help slow the progression.
What Causes It?
Several different conditions can damage the kidneys and eventually lead to kidney disease, including the following:
- High blood pressure
- Type 1 or type 2 diabetes
- Recurrent kidney infections
- Prolonged urinary tract obstruction
Although anyone can develop kidney disease, smoking, obesity, and a family history of kidney disease also increase your risk.
Kidney Disease Stages: Symptoms and Treatment
Doctors measure kidney function in part through a blood test called the estimated glomerular filtration rate (eGFR). The blood test checks the amount of creatinine, which is a waste product in the blood. The level of creatinine is an indication of how well the kidneys are functioning. An eGFR of above 60 is considered normal.
The five stages of kidney disease, including symptoms and treatments are listed below.
In stage 1 kidney disease, the eGFR is usually 90 or more. Although the eGFR is normal, a person may have protein in the urine, which is also a sign of kidney disease. In many cases, someone with stage 1 kidney disease may not have any symptoms.
Treatment: Treatment is aimed at slowing down the progression of the damage. Usually, lifestyle changes are recommended and may include:
- Controlling blood sugar levels and managing diabetes
- Eating a healthy diet
- Quitting smoking
- Controlling blood pressure
- Maintaining a healthy weight
When kidney disease progresses to stage 2, the eGFR level is usually between 60 to 80, which is in the normal range. But other signs of kidney disease are present. Symptoms at this stage may include protein in the urine and physical damage to the kidneys. Typically, the kidneys are still functioning well enough that additional symptoms are not present.
Treatment: To slow the progression of the disease, you should make all the lifestyle changes recommended with stage 1 disease. In addition, talk with your doctor about any medications you should consider that may protect the kidneys.
By stage 3 kidney disease, eGFR levels are usually abnormal and between 30 to 59.
Some people with stage 3 start to develop symptoms. Symptoms may vary in severity and may include:
- Swelling in the feet, legs, and hands
- Urinating more or less than normal
- Back pain
- High blood pressure
Treatment: Treatment for stage 3 disease is intended to prevent progression and treat symptoms. In addition to lifestyle changes, treatment may include:
- Seeing a kidney specialist. If you have not yet seen a nephrologist (kidney specialist), it may be a good time. A nephrologist will develop a treatment plan and schedule to evaluate kidney function.
- Talking with a dietitian to develop a healthy diet to limit salt and reduce potassium.
- Taking blood pressure medications. In some cases, your doctor may recommend you take medications, such as ACE inhibitors, to lower blood pressure.
People with stage 4 chronic kidney disease usually have an eGFR between 15 and 29, which means your kidneys are significantly damaged. Symptoms may increase in this stage and include:
- Increased swelling in the legs and hands
- Bone pain
Treatment: Treatment for stage 4 kidney disease often includes everything in stage 3. If you have not started taking medication to control blood pressure, you may start in stage 4. It is also a good time to discuss a treatment plan if you progress to stage 5.
Often, dialysis is needed for people with stage 5 kidney disease. There are different types of dialysis, including peritoneal and hemodialysis. During stage 4 disease, it is a good time to talk with your doctor and learn more about each type to determine what is best for you.
Stage 5 is the final stage of chronic kidney disease. The eGFR is less than 15, and it indicates near or complete kidney failure. When the kidneys no longer work, waste builds in the body, which leads to a variety of symptoms.
Symptoms of kidney failure may include:
- Muscle pain
- Trouble breathing
- Loss of appetite
Treatment: Once kidney failure occurs, you will need to start dialysis. Dialysis filters the blood and does the job of the kidneys. Hemodialysis can be done at home or at a center. It involves using a machine that cleans the waste out of the blood.
Peritoneal dialysis works a little differently. It involves using a fluid called dialysate, which is circulated through a catheter in the peritoneal cavity. The fluid absorbs waste from the vessels in the peritoneum, and it is drawn out of the body. Peritoneal dialysis can be done at home.
Another option for some people with stage 5 kidney failure is a kidney transplant. The transplant process is long and may not be right for everyone. Both living and deceased donors may provide kidney donation. If you are interested in a kidney transplant, talk to your doctor to determine if you are a good candidate.