Chronic Kidney Disease Tests and Stages

Chronic Kidney Disease or CKD is a long-term condition that means your kidneys aren’t working properly. The Centers for Disease Control and Prevention states that around 37 million American adults have CKD. More than that, it’s alarming to know that 9 out of 10 adults don’t even know that they have it. Five out of 10 of these adults have a severe case already and they aren’t even aware of it.

This is surprising because severe CKD doesn’t just happen. Kidneys don’t just fail. It’s usually a slow progression that happens over several years.

That means you have a lot of time to detect if your kidneys are getting damaged. The earlier you can detect the disease, the higher the chance that you can reverse its effects and save your kidneys. Even a simple lifestyle change may be enough to keep the disease from progressing.

But you have to be certain about the CKD stage you’re in to know what you have to do.


Two Ways Kidney Specialists Determine CKD Stages

As you age, your kidneys will fail over time. If you want to make sure your kidneys are still okay, you need to go through tests to know the specific treatments you should do to save them.

The question is, how does one determine the CKD stage?

There are two specific ways to determine if you have CKD and what stage you’re in.

eGFR Tests

eGFR stands for estimated glomerular filtration rate. This is the measurement used to see just how well your kidneys are functioning.

This is basically a blood test. It will estimate the creatinine levels in the blood sample. Creatinine is the waste product that goes to your blood from every muscle activity. It’s the kidney’s job to remove this waste from your blood to clean it. If your kidneys aren’t functioning properly, there’ll be a higher level of creatinine in your blood.

But creatinine isn’t the only factor that’s considered when testing for your CKD stage. Your blood test, sex, age, race, and body type are also taken into account.

eGFR is considered by many kidney specialists to be the most reliable test to check your kidneys. However, if you’re pregnant, overweight, too muscular, or under the age of 18, the test might not be advisable for you.

It has to be noted that eGFR will be calculated differently over time. Organizations like the American Kidney Fund (AKF), the American Society of Nephrology (ASN), and the National Kidney Foundation (NKF) are working to make this test as accurate as possible. Over time, considerations like race may be altered to get more accurate results.


Urine Tests

The other option used by doctors to determine CKD Stage is a urine test. You see, when your kidneys aren’t functioning properly, they’ll leak protein into your urine or proteinuria. When proteinuria is detected in a urine test, it’s considered an early sign of CKD.
There are two ways this urine test is done.

One is through a dipstick urine test. The other is through a urine albumin-to-creatinine ratio or UACR.

Usually, physicians will ask you to take a urine test first. If there are traces of proteinuria in it, you can go through an eGFR to get a better idea of the CKD stage you’re in.


5 Chronic Kidney Disease Stages

Once you’ve gone through proper testing, the kidney specialist will determine the specific CKD stage you’re in. With this knowledge, they’ll provide the best treatment to hopefully save your kidneys and your life.

CKD Stage 1: eGFR > 90 mL/min
When you have stage 1 CKD, it means your kidneys are still working well, but they’re showing signs of damage. To help slow the progression down, do the following:

  • Monitor and regulate your blood pressure.
  • Eat healthier meals and maintain your ideal weight.
  • Stop smoking.
  • Stay active for at least 30 minutes every day, 5 times a week.
  • If you have diabetes, make sure your blood sugar is controlled.

CKD Stage 2: eGFR 60 to 89 mL/min
This stage means you already have mild kidney damage, or mild CKD. Your kidneys are still functioning, but you have to take better care of them. To protect your kidneys, do the recommendations in CKD stage 1 and include the following:

  • Consult with your doctor if you can take medication to protect your kidneys.
  • Go to a nephrologist or kidney specialist to test your kidneys further.

CKD Stage 3: eGFR 30 to 59 mL/min
This is a more serious CKD stage than the first two. It’s called moderate CKD. This means there is damage to your kidneys. They are no longer functioning as they are meant to.

At this stage, you’ll start to see symptoms of your kidney disease. This includes back pain, swelling of hands and feet, and irregular urination (either peeing more or less than usual). Usually, this comes with other health conditions like anemia, bone disease, or high blood pressure.

To keep your CKD from getting worse, do all the recommendations of CKD stage 1 and add the following:

  • Consult with your doctor if you can take medicines like ARBs and ACE inhibitors to keep your kidneys from getting worse. This is applicable to those who have high blood pressure or diabetes.
  • Go to a nephrologist or kidney specialist to discuss a treatment plan that can help your kidneys recover.
  • Ask a dietitian to help you create a healthy diet that you can follow.

CKD Stage 4: eGFR 15 to 29 mL/min
Stage 4 is also known as severe CKD. This is an indication that your kidneys are moderately to severely damaged. This is a great cause for concern because your kidneys aren’t working enough to keep your body healthy. This is your last chance to save your kidneys before they completely fail.

Stage 4 comes with symptoms like swelling of your hands and feet, irregular urination, and back pain. This could also mean you have other serious ailments like bone disease, anemia, and high blood pressure.

Helping your kidneys in Stage 4 will take more than a lifestyle change. You have to do the following:

  • Set regular appointments with your nephrologist. They should give you a treatment plan to regularly have your kidneys checked and monitored.
  • Consult with your doctor so you can start taking ACE inhibitors or ARBs to help with your blood pressure. If your kidneys are failing because of high blood pressure or diabetes, this could help.
  • Ask a dietician to help you create a healthy diet that can make your kidneys healthier.

At this point, you should talk to your nephrologist about the possibility of getting dialysis or a kidney transplant.

CKD Stage 5: eGFR < 15 mL/min
This is the end-stage CKD. When you reach this point, it means your kidneys have already failed – or are very close to failing, and there’s nothing you can do to stop it.

Your body will show signs that this is happening. You’ll experience itching, swelling in your hands and feet, nausea and vomiting, muscle cramps, back pain, trouble breathing, and sleeping, and irregular urination.

With damaged kidneys, there’s nothing cleaning waste from your blood. It will make you feel very sick. There are only two things you can do. One is to go through regular dialysis, wherein a machine cleans your blood for you. The other is to find a healthy kidney donor and have transplant surgery.



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