Early Stages Before Kidney Failure
Chronic kidney disease (CKD) is a largely irreversible, long-term disease characterized by the gradual loss of kidney function over months or years. Stages 1, 2, and 3 are considered the early stages, during which you may have few, if any, symptoms.
Stage 1 CKD
Stage 1 CKD is when there is some kidney damage but eGFR is still in the normal range (90 and above). The diagnosis is made when a test called an albumin/creatinine ratio (ACR) shows the excessive loss of a protein called albumin in your urine.
Stage 1 CKD rarely causes notable symptoms. Even so, steps would be taken to preserve kidney function. Key to this is managing hypertension (high blood pressure) and diabetes, which account for up to 51% and 66% of CKD cases, respectively. Recommended interventions include:
- Managing hypertension
- Managing diabetes
- Quitting smoking
- Losing weight
- Exercising regularly
- Limiting sodium and protein intake
Stage 2 CKD
Stage 2 CKD occurs when you have mild kidney damage and your eGFR has dropped to between 60 and 89. However, your kidneys can still filter blood, and your risk of symptoms remains low. If symptoms occur, they tend to be nonspecific, meaning they could be due to several other conditions.
Recommended interventions include:
- Managing hypertension
- Managing diabetes
- Quitting smoking
- Losing weight
- Exercising regularly
- Limiting sodium and protein intake
- Monitoring blood pressure and blood sugar levels
Stage 3 CKD
Stage 3 CKD is when your kidneys have sustained mild to moderate damage and your eGFR has decreased to between 30 and 59. This stage is further divided into two substages:
- Stage 3a: eGFR between 45 and 59
- Stage 3b: eGFR between 30 and 44
Palliative Care
Palliative care focuses on alleviating pain, stress, and other symptoms while undergoing medical treatment. It is delivered by a specialized team of providers who aim to improve the quality of life of individuals with CKD as well as those of their families.
Disease Progression and Prognosis
Not everyone with CKD will experience progression, particularly if the appropriate preventive steps are taken. However, people who fail to control their blood pressure or blood sugar will commonly see a steady decline in their eGFR. This increases the risk of stages 4 and 5 CKD.
Life Expectancy
Only around 2% of people with CKD progress to end-stage renal disease, most often after the age of 65. If ESRD is diagnosed, dialysis or a kidney transplant can dramatically extend life expectancy. Based on current research:
- With dialysis, the average life expectancy for someone with ESRD is between five and 10 years, although some people have been known to live for as long as 30 years.
- With a kidney transplant, the average life expectancy is between 20 and 25 years if the kidney is from a living donor and 15 to 20 years if the kidney is from a deceased donor.
Summary
Chronic kidney disease (CKD) progresses in five stages. Stages 1, 2, and 3 are considered the early stages of CKD when symptoms are often absent. Stages 4 and 5 are the advanced stages when kidney damage can cause severe symptoms and lead to kidney failure. With lifestyle changes, dietary management, and medications, CKD progression can be slowed or altogether stopped. If CKD is allowed to progress and kidney failure occurs, dialysis and a kidney transplant are the only treatment options.
Frequently Asked Questions
- What are the early stages of CKD?
- Stages 1, 2, and 3
- What are the symptoms of CKD?
- Rarely present in early stages, but may include fatigue, swelling, and pain in later stages
- What are the recommended interventions for early stages of CKD?
- Managing hypertension, diabetes, quitting smoking, losing weight, exercising regularly, and limiting sodium and protein intake
- What is palliative care?
- Focuses on alleviating pain, stress, and other symptoms while undergoing medical treatment
- What is the average life expectancy for someone with ESRD?
- 5-10 years with dialysis, 20-25 years with a kidney transplant from a living donor, and 15-20 years with a kidney transplant from a deceased donor
