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Stages of Kidney Disease

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Kidneys, the bean shaped organs located on either side of the body, help remove toxins and excess water from blood and body fluid. They help maintain the balance of electrolytes and if required, they help retain water in the body too. This way, they play an important role in maintaining the normal level of blood pressure. Usually, aged people suffer from diminished kidney function. Dysfunction of kidneys is called kidney disease or renal disease. Those suffering from diabetes, high blood pressure, or those who have a family history of kidney disease are at an increased risk for developing chronic kidney disease (CKD). Kidney dysfunction eventually leads to cardiovascular disease.


What is Chronic Kidney Disease?

When kidneys slowly lose their ability to function, the person is said to have CKD. The disease progresses slowly. It should be noted that “chronic” does not mean “severe”. Chronic disease refers to a condition that despite of the treatment never gets completely cured; for example, diabetes, and hypertension. 

Extremely tiny blood vessels in the kidneys called glomeruli help filter the blood and promote formation of urine. Inflammation or scarring of glomeruli affects the glomerular filtration rate (GFR), the rate at which the waste material is filtered by the glomeruli, each minute. GFR measurement helps evaluate kidney function.

A GFR of 90 mL/min or more is considered as normal. If a person has GFR < 60 mL/min for consecutive three months, then he is said to have CKD. In such case, whether he is suffering from kidney damage or not is not taken into consideration. Similarly, those who have damaged kidney are said to have CKD, irrespective of the GFR. Apart from declining GFR, loss of protein through urine also indicates presence of CKD and cardiovascular disease. CKD is divided into five stages, depending upon the declining GFR.


Five Stages of Chronic Kidney Disease

Stage I

A person having slightly diminished kidney function due to damaged kidney is said to have CKD irrespective of normal or comparatively higher GFR (90 mL/min or more). The person may not exhibit symptoms of kidney disease and so, it is difficult to determine whether he has the disease. But if diagnosed, it is easier to treat the disease at this stage and with proper treatment; it can even be reversed.

Stage II

Even at this stage, the person may not exhibit any symptom of diminished kidney function. The GFR can be between 60 and 89 mL/min. If the disease is diagnosed at this stage, the person would not require dialysis and the treatment can be relatively simpler. The treatment would slow down the progression of CKD. The patient may not have to suffer from other health complications. 

Stage III

GFR between 30 and 59 mL/min indicates third stage of CKD. At this stage, the patient usually shows symptoms like constant fatigue, foamy urine, change in the color of the urine, difficulty sleeping and swollen legs, hands and eyes due to water retention. The disease can be controlled with proper medication. Monitoring kidney function regularly would help assess the effect of medication. The treatment can help lower the severity of other health problems. 

Stage IV

Severely reduced GFR (15–29 mL/min) indicates an advanced stage of CKD. Bad breath due to increased urea in blood, loss of appetite, nausea, vomiting, tingling sensation or numbness in fingers, and little urination are some of the main symptoms shown by the patient. The doctor may suggest dialysis or kidney transplant. 

Stage V

A seriously damaged glomerular tissue leads to renal failure or end stage renal disease (ESRD). At this stage, kidneys almost stop working. GFR can be less than 15 mL/min. The treatment options for these patients are dialysis and renal transplantation.

An early and timely diagnosis of kidney disease helps slow the progression of the disease and can also lower the risk of cardiovascular disease. It should be noted that it can take many years to go from the first stage of CKD to the last stage. It has been observed that most CKD patients never reach the last stage of the disease.

Various blood tests, MRI, X-ray, CT scan and ultrasound can help detect kidney disease at an earlier stage. The risk of CKD increases with age. People over 65 are more likely to develop CKD than the people belonging to the age group of 45 - 65. Therefore, senior citizens, especially those having diabetes should undergo routine checkups without hesitation.

Written by: Healthplus24 team
Date last updated: April 19, 2013