Understanding the Stages of Chronic Kidney Disease (CKD)

Chronic Kidney Disease (CKD) is a long-term condition where the kidneys slowly stop working well. Kidneys help clean your blood, remove waste, and balance fluids. When they stop working properly, waste can build up in your body, causing serious health problems.

The disease often progresses slowly, and many people don’t notice symptoms in the early stages. That’s why doctors use different stages of chronic kidney disease to explain how serious it is and what treatment may be needed.

What Determines the Stage of CKD?

The stage of CKD is determined using two main tests:

• Estimated Glomerular Filtration Rate (eGFR): This is a blood test that shows how well your kidneys filter waste. A lower eGFR means your kidneys are not working as well. (Source: National Kidney Foundation)

• Urine Albumin-to-Creatinine Ratio (uACR): This urine test looks for protein (albumin) in your urine. If your kidneys are damaged, protein can leak into the urine. (Sources: National Kidney Foundation, AAFP, ResearchGate)

Doctors diagnose CKD when there is kidney damage or a low eGFR for at least three months. These tests help identify the different stages of chronic kidney disease early, even before you feel sick.

What Are the Five Stages of CKD?

The five stages of CKD are based mainly on eGFR levels. Here's what each stage means:

Stage 1 (eGFR 90 or higher): Kidney function is normal, but there may still be signs of damage, like protein in the urine. People in this stage often have no symptoms. It’s important to manage blood pressure, blood sugar, and other health issues to protect the kidneys.

Stage 2 (eGFR 60–89): This stage shows mild loss of kidney function. The kidneys are still working quite well, but damage is starting. Regular check-ups and a healthy lifestyle are important at this stage of CKD.

Stage 3 is split into two parts. In Stage 3a (eGFR 45–59) and Stage 3b (eGFR 30–44), kidney function is moderately reduced. Some people may start to feel tired or notice swelling. Doctors may recommend medicine, diet changes, or seeing a kidney specialist.

Stage 4 (eGFR 15–29): This is a severe loss of kidney function. You may feel sick, and it’s time to start planning for treatments like dialysis or a transplant. Doctors will work closely with you to manage symptoms and prevent further damage.

Stage 5 (eGFR less than 15): This is kidney failure. Your kidneys can no longer clean your blood properly. Most people in this stage need dialysis or a kidney transplant to live.

These stages of chronic kidney disease CKD help doctors know when to act and how to protect your health.

How the Disease Affects Men vs. Women

The eGFR calculation is slightly different for men and women because of differences in body size and muscle mass. However, the stages of CKD are the same for everyone, but their effects are slightly different. 

Stage	eGFR Range	How the Disease Affects (Men vs. Women)
Stage 1	90 or higher	Usually, there are no symptoms. More women than men are diagnosed, but men may progress faster over time.
Stage 2	60–89	Still a few symptoms. Women remain more likely to be diagnosed; men’s kidney function may start declining more rapidly.
Stage 3a	45–59	Symptoms like tiredness or swelling may appear. Men have a higher risk of faster progression and complications.
Stage 3b	30–44	More pronounced symptoms. Men continue to progress faster; women may report more symptoms but experience a slower decline.
Stage 4	15–29	Severe symptoms, high risk of kidney failure. Men are more likely to need dialysis sooner; women may choose conservative care.
Stage 5	Less than 15	Kidney failure. Men reach this stage more often and earlier; women have higher symptom burden and lower transplant rates.

Why Knowing the Stage Is Important

Knowing which stage of CKD you have helps your doctor make the best plan to care for you. The earlier you find out, the more you can do to protect your kidneys. The different stages of chronic kidney disease show how much damage there is and whether treatment should be started soon.

Even in the early stages of CKD, where there are no symptoms, silent damage may already be happening. That’s why regular testing is so important, especially if you have diabetes, high blood pressure, or a family history of kidney disease.

Conclusion

Understanding the stages of CKD helps you take control of your health. Even though kidney disease can get worse over time, early testing and good care can protect your kidneys and delay serious problems. Talk to your doctor if you think you might be at risk and ask for a kidney health check-up today.