The RenalTracker Team
May 31, 2022

I hope you enjoy reading this blog post. It has been written and vetted by RenalTracker's team of kidney experts and researchers. The same team was awarded the KidneyX Prize organized by the American Society of Nephrology and HHS for pre-dialysis solution in Washington DC in 2019.   

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If you have chronic kidney disease (CKD), you may wonder how far it will progress and your options for treatment. While there's no cure for CKD, several treatments can help slow down the progression. CKD, also known as renal disease, is a chronic condition where the kidneys don't function as well as they should. Left untreated, CKD can progress quickly, causing severe medical complications for the patients. There are different stages of CKD; each comes with its own symptoms and treatments. The last step of CKD, called End-Stage Renal Disease (ESRD), requires patients to have dialysis or a kidney transplant.

Is CKD reversible?

You can possibly stabilize or reverse some kidney injuries at the early stages of the disease. However, CKD typically doesn't present symptoms in its initial phases, making patients oblivious to their condition. Since they don't know they have CKD, they can't make the necessary changes. People with CKD might learn about their CKD through a random blood test result from other diseases such as diabetes or hypertension. 

If your kidneys are scarred from a previous condition such as kidney stones or an infection, there are no known cures for reversing irreversible damage. Thus, even if you treat the cause of your CKD and manage to clear up some of its symptoms like fatigue and nausea, these improvements will not last forever because they aren't addressing the root cause of why your kidneys aren't working properly anymore. Meanwhile, if you have diabetes or high blood pressure, you can reverse these conditions with sustained treatment. 

CKD is a progressive disease, meaning it gets worse over time. If left undiagnosed or untreated, it can lead to serious health problems and kidney failure. It's essential to understand how CKD will impact you so that you can take steps to manage the condition the best way possible.

What is the progression of CKD?

As your kidneys lose function over time, they will not be able to remove wastes from your blood at the same rate as before. The buildup of waste will then start to put pressure on other organs like the liver and heart. The more advanced stages of kidney damage are called end-stage renal disease (ESRD).

Doctors will conduct a series of tests to determine the stages of CKD. These tests include eGFR, a blood test that measures how well your kidneys are working, and Urine tests. The calculation of eGFR will change as it considers age, sex, and race, among other things. 

The stages of CKD

What is stage 1 CKD?

If you have stage 1 kidney disease and aren't doing anything about it, you could progress to stage 2 or 3 in just a few years—in which case your kidneys will be working at less than 50% capacity (if not worse). At Stage 1, your eGFR is 90 or greater with mild kidney damage. CKD symptoms typically emerge at advanced levels, such as stage 4 and above. 

What is stage 2 CKD?

Stage 2 kidney disease is when your kidneys are still working to a degree, but a weakened state. You may not notice anything wrong since your body still produces some urine. However, as the glomerular filtration rate (GFR) drops from stage 1 to stage 2, you may need to start taking medication for high blood pressure and high cholesterol. At this stage, GFR reads between 60 and 89. 

If you go any further down the CKD chain and reach stage 3 or 4, you will need medications for these conditions and other complications that arise from kidney failure, such as anemia. 

What is stage 3 CKD?

Stage 3 CKD is a common term used to describe the stages of kidney damage where you have a GFR between 30 and 59 mL/min/1.73 m2

The kidneys are essential organs in our bodies that perform many vital functions: filtering waste products out of our bloodstream; regulating blood pressure; helping us maintain fluid balance by producing hormones that control fluid levels in our body; helping us digest food and eliminate waste products through urination, and making red blood cells that transport oxygen throughout your body.

In stage 3 CKD, the kidneys are not working as well as they should be because they've been damaged over time by excessive amounts of wastes or toxins being filtered into them from our bloodstream. This can lead to fatigue due to dehydration from excessive urination, low sodium levels (hyponatremia), and excess fluid buildup (edema) around swollen body parts like ankles. This is due to water retention caused by reduced salt intake when drinking more than usual liquids.

It's recommended to have regular checkups by your nephrologist to monitor your kidneys regularly. Your nephrologist may recommend a renal dietitian to customize your meal plans. Stage 3 CKD needs delicate dieting to balance the amount of required nutrients inside the body. It would be best to work closely with your dietitian on a custom meal plan that meets your nutritional requirements. 

What is stage 4 CKD?

GFR is between 15 and 29 at stage 4 CKD, where your kidney functions are severely reduced. The waste buildup can spike your blood pressure,  cause bone disease, and heart disease. Additionally, you may experience symptoms such as nausea, lack of focus, change in taste, loss of appetite, nerve problems, etc. 

What is stage 5 CKD?

CKD, your kidneys no longer function at a level necessary to keep your body healthy. GFR is less than 15 and severe damage to the kidneys. Kidneys are getting very close to failure or have already failed to function. Since the kidneys no longer filter waste out of your blood, waste products build up in your body. Stage 5 kidney disease can also be called an end-stage renal failure or end-stage renal insufficiency. Regulating blood pressure and producing hormones for red blood cell formation may also be compromised. If you are diagnosed with stage 5 CKD, you must see a nephrologist. They will suggest the best treatment for you – hemodialysis, peritoneal dialysis, or kidney transplant.

It's easier to manage CKD if you catch it before it progresses to later stages.

You can manage CKD better if you catch it before it progresses to later stages.

The earlier you catch it, the better your chances of reversing CKD. When you're diagnosed with stage 1 or 2 CKD, there are several things you can do on your own or with a doctor that may help keep the disease from getting worse. These include:

  • Getting regular checkups

  • Watching your meds

  • Eating a healthy diet

  • Managing Weight and other medical conditions

Getting Regular Checkups

If you have an underlying condition such as diabetes, obesity, diabetes, or a family history of CKD, you must see a doctor to get screened for CKD. This way, you can manage your kidney disease's early stages and slow its progression. On the other hand, a regular checkup also helps monitor your CKD stage and kidney health if you already have it. 

meds to avoid

Watching your meds

Avoiding over-the-counter painkillers such as acetaminophen, non-steroidal anti-inflammatories, or aspirin is essential if you have early-stage chronic kidney disease. According to the National Kidney Foundation, all of these drugs can damage kidney tissue and reduce blood flow. This is especially true if you're elderly.

Eating a healthy diet.

Certain foods can worsen your chronic kidney disease. Several studies show that a plant-based diet helps lower blood pressure and blood sugar levels, which are essential in ensuring kidney health. Before making any dietary changes, please check in with your nephrologist to determine if a plant-based diet is suitable for your CKD stage.

On the other hand, you may need to cut back on nutrients such as sodium, potassium, protein, and phosphorus, as they can damage the kidneys. The National Kidney Foundation recommends keeping your sodium intake under 2300 milligrams daily. You may also want to moderate your daily protein intake slightly; the rule of thumb is 0.8 grams per kilogram or roughly 55 grams of protein a day for a 150-pound person, says the National Kidney Foundation. Note that this suggested daily protein intake doesn’t apply to all CKD stages. In the later stages of kidney disease, you may also need to restrict potassium and phosphorous.

Managing Weight and other medical conditions

Keeping a healthy weight can help you feel more energetic and improve your health. It's especially important for people with kidney disease to maintain a healthy weight because it reduces stress on the body's immune system, blood vessels, and heart. In turn, this helps keep kidneys working properly longer.   By taking steps to protect your kidneys, you may also prevent heart disease and improve your overall health. It can be hard to make these changes if you don’t have symptoms, but doing so is worthwhile. Learn to keep a healthy weight by clicking this link. 

The most important step you can take to treat kidney disease is to control your blood pressure. High blood pressure can damage your kidneys. Click this link to learn about managing blood pressure when you have CKD. 

 If you have diabetes, make sure to check your blood glucose level regularly. Use the results to help guide decisions about food and activity. Ask your health care provider how often you should check your blood glucose level. Here’s an ultimate guide to managing diabetes and kidney disease. 

The Bottomline

If you have CKD, it's essential to understand the different stages of this condition and how it progresses. If you can catch it early, your chances of reversing or slowing down the progression are much higher than if you wait too long before seeking treatment. When you feel like your health is declining, seek medical attention immediately—the sooner you become aware of this condition, the better your chances of preventing serious complications.