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The 5 Stages of CKD

The 5 Stages of CKD

When it comes to Chronic Kidney Disease or CKD, the kidneys don’t fail all at once. It is a progressive condition that evolves through five distinct stages. Each stage presents its own set of symptoms, ranging from subtle signs to more pronounced indicators of declining kidney function. Understanding the symptoms and stages of CKD makes it possible for the condition to be treated. Timely diagnosis can pave the way for effective treatment, and can additionally even slow down disease progression.

Through this blog we’ll explore the symptoms of each stage of CKD, and throw light on India’s no. 1 CKD rehabilitation program only at Plexus’ centers in Bangalore and Hyderabad.

What is CKD?

Chronic Kidney Disease (CKD) is a long-term condition where the kidneys do not function properly. Over a period of time, the kidneys gradually lose their ability to perform this function effectively, leading to a buildup of waste in the body. This may happen due to some or a combination of the following:

  • Diabetic neuropathy
  • Polycystic kidney disease
  • Hypertension
  • Autoimmune conditions, such as rheumatoid arthritis and lupus
  • Glomerulonephritis
  • Repeated kidney infections
  • Urinary tract obstructions, such as kidney stones and enlarged prostate
  • Congenital kidney problems
  • Reaction to certain medications, such as non-steroidal anti-inflammatory drugs (NSAIDs)
  • Exposure to toxins
  • Family history
  • Chronic dehydration
  • Aging
  • Obesity
  • Smoking

Based on the Glomerular Filtration Rate (GFR),  CKD is categorized into five stages. These stages range from Stage 1 (mild) to Stage 5 (end-stage kidney disease).

Determining the Stages of CKD

The various stages of CKD are determined by the Glomerular Filtration Rate (GFR). Measuring the GFR is the best way to gauge the scenario and determining the stage of CKD helps doctors resolve the tests and treatments that each of these stages calls for.

How is Glomerular Filtration Rate calculated?

A mathematical formula is used by doctors to calculate GFR and this formula is based on the patient’s age, gender, race and the levels of Creatinine in their blood. Creatinine is the waste that is expelled from the muscles of the body. When the kidney function dips, creatinine levels escalate. Though there are 5 stages of classification, the kidney function is normal in stage 1 and is only slightly diminished in stage 2.

Let’s take a look at the five stages of CKD and their GFR values:

Stage 1 CKD is normal or high GFR ( > 90 mL/min)

This stage typically goes unnoticed as most individuals are asymptomatic. The kidneys have mild damage but can still function in their normal capacity. Some subtle symptoms may include:

  • Changes in urination: increased frequency, color change
  • Microscopic amounts of protein or blood in urine
  • High blood pressure

Stage 2 CKD is mild (GFR = 60-89 mL/min)

Much like stage 1 CKD, stage 2 can also go unnoticed. Characterized by a mild reduction in kidney function, this stage may present the following symptoms:

  • Changes in urination: increased frequency, color change
  • Increased levels of protein (proteinuria) or blood (hematuria) in urine
  • High blood pressure
  • Fluid retention
  • Fatigue

Individuals with diabetes and hypertension need to be wary of the symptoms of stages 1 and 2.

Stage 3A CKD is moderate (GFR = 45-59 mL/min)

Characterized by a mild decline in kidney function, stage 3A of CKD can present the following symptoms:

  • Changes in urination: increased frequency, color change, increased urination at night (nocturia)
  • Increased levels of protein (proteinuria) or blood (hematuria) in urine
  • High blood pressure
  • Fluid retention
  • Fatigue
  • Muscle cramps (caused by electrolyte imbalance)
  • Irregular heart rate (caused by electrolyte imbalance)
  • Weak bones
  • Bone pain

Stage 3B CKD is moderate (GFR = 30-44 mL/min)

Apart from the symptoms of stage 3A CKD, stage 3B can present the following symptoms:

  • Loss of appetite
  • Unexplained weight loss
  • Impaired cognitive function (brain fog, concentration troubles)

This stage may be classified as moderate to severe kidney dysfunction

Stage 4 CKD is severe (GFR = 15-29 mL/min)

Representing severe decline in kidney function, stage 4 CKD may require more critical intervention, such as dialysis and kidney transplant. Apart from the symptoms of stages 3A and 3B, the following symptoms may present at stage 4:

  • Shortness of breath
  • Nausea
  • Vomiting

Stage 5 CKD is in the End Stage (GFR < 15 mL/min)

Also known as End-Stage Renal Disease (ESRD), stage 5 CKD is indicative of critical decline in kidney function. By now, the kidneys are incapable of normal to adequate functioning. The symptoms at this stage include:

  • Persistent fluid retention
  • Severe fatigue
  • Minimal urine production or complete cessation
  • Unmanageable high blood pressure
  • Advanced electrolyte imbalance
  • Severe proteinuria and hematuria
  • Increased nocturia
  • Impaired cognitive function
  • Shortness of breath 
  • Chest pain
  • Skin color change and itching (caused by uremic toxins in the blood)
  • Nerve damage (neuropathy) and muscle twitching (caused by accumulation of waste)

Stem Cell Therapy for Kidney Regeneration at Plexus

At Plexus, we offer advanced stem cell therapy for CKD with the aim to repair and regenerate damaged kidney tissue. We use mesenchymal stem cells (MSCs) or renal progenitor cells for that can:

  • Transform into kidney-specific cells, namely endothelial cells,  and replace damaged or lost ones
  • Secrete growth factors that stimulate tissue repair and regeneration
  • Reduce inflammation and prevent further damage to the kidneys by modulating immune response

It is important to keep in mind that stem cell therapy for CKD can be a viable treatment approach in the initial stages of the disease. Stages 4 and 5 are critical and require renal replacement therapies, such dialysis or kidney transplant. Early detection not only preserves kidney function but also prevents complications associated with advanced CKD. 


Can Stage 3 kidney damage be cured?

Stage 3 kidney damage is usually not fully reversible. However, proactive management in the form of regenerative medicine (stem cell therapy) can slow its progression. Additionally, lifestyle changes, medication, and addressing underlying causes can significantly improve the individual’s quality of life.

Is Stage 3 kidney disease serious?

Stage 3 CKD should be regarded as moderately serious. It alerts a decline in kidney function, and even though it is not as critical as end-stage CKD, immediate intervention is vital to prevent further deterioration.

What is the best treatment for stage 3 kidney disease?

Treatment for stage 3 CKD focuses on managing underlying conditions, lifestyle modifications, and medications to control blood pressure and address complications. At Plexus, we also offer stem cell therapy to stall disease progression and help improve quality of life.

What stage of CKD is the end stage?

Stage 5 CKD is end-stage. With kidney function severely impaired, individuals need dialysis or a kidney transplant.

How quickly does CKD progress?

This can vary on a case to case basis. Some determining factors include the underlying cause, lifestyle, and treatment adherence. Timely detection, altered lifestyle, and medical interventions can definitely slow down disease progression, thereby emphasizing the criticality of regular monitoring.

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