Your kidneys play a crucial role in maintaining your overall health by filtering blood, removing waste, and regulating functions like blood pressure and red blood cell production. When kidney function declines due to chronic kidney disease (CKD), however, the early warning signs may be subtle or absent altogether. This makes routine screenings vital for early detection and intervention.*

Detecting Chronic Kidney Disease

In the early stages of CKD, symptoms are often minimal or mistaken for other conditions. Many people remain unaware of kidney decline until routine blood or urine tests reveal abnormalities. CKD is typically diagnosed through an estimated glomerular filtration rate (eGFR) test, which assesses kidney function by measuring creatinine levels in the blood.

The five stages of CKD are classified based on eGFR values:

• Stage 1 (eGFR 90-100). Normal kidney function with possible signs of damage
• Stage 2 (60-89). Mild kidney damage, often without symptoms
• Stage 3a (45-59). Mild to moderate kidney damage, with emerging symptoms
• Stage 3b (30-44). Moderate to severe damage, with noticeable effects
• Stage 4 (15-29). Severe kidney damage, requiring preparation for dialysis or transplant
• Stage 5 (eGFR <15). End-stage kidney disease, necessitating dialysis or transplant

In addition to eGFR, urine tests checking for protein or blood can further assess kidney health. Regular monitoring by a nephrologist ensures timely intervention and management.

Progression of Symptoms Across CKD Stages

Early Stage Symptoms (Stages 1 and 2)

At the earliest stages, kidney function remains strong, and symptoms are minimal, but urine tests may detect higher protein levels or early signs of kidney stress. Some people might experience high blood pressure or mild urinary tract infections.

Middle Stage Symptoms (Stages 3 and 4)

Symptoms usually emerge at stage 3, with common signs including:

• Swelling (edema) in hands, feet, and ankles due to fluid retention
• High blood pressure
• Changes in urination frequency
• Kidney pain in the back

As CKD progresses to stage 4, additional symptoms develop, such as:

• Nausea and vomiting
• Metallic taste in the mouth
• Loss of appetite and weight loss
• Difficulty concentrating and nerve-related issues like numbness in extremities

At this stage, medical intervention becomes more urgent, with discussions around dialysis or kidney transplant planning.

End-Stage Kidney Disease (Stage 5)

At stage 5, the kidneys lose nearly all function, leading to severe complications and kidney failure. Symptoms include:

• Persistent nausea, vomiting, and appetite loss
• Severe swelling and fluid buildup, causing breathing difficulties
• Muscle cramps, skin discoloration, and tingling sensations
• Minimal or no urine production

Treatment at this stage requires either dialysis to replace kidney function or a kidney transplant for long-term survival.

Managing CKD at Any Stage

A nephrologist will help you develop a personalized treatment plan to slow CKD progression. Key management strategies include:

• Medications to control high blood pressure and diabetes
• A kidney-friendly diet low in sodium, phosphorus, and protein
• Regular exercise and healthy weight maintenance
• Avoiding smoking and stress management

Early detection and proactive management are critical in preserving kidney function. If you experience any concerning symptoms, consulting a doctor can make a significant difference in long-term health outcomes.

*Rosenthal, B. (2024, November 22). 5 Stages of Chronic Kidney Disease. Virtua Health. https://www.virtua.org/articles/5-stages-of-chronic-kidney-disease 

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