Imagine your kidneys as your body’s natural filters—working silently every day to remove waste, balance fluids, and regulate blood pressure. When they start to fail, the decline often happens gradually, in stages. This leads to one of the most common questions people ask: “How many stages of kidney disease are there?”
The short answer is: there are 5 stages of chronic kidney disease (CKD). Each stage reflects how well your kidneys are working, based on a measurement called the glomerular filtration rate (GFR). The lower the GFR, the more advanced the disease.
In this article, we’ll break down all 5 stages of kidney disease, what symptoms to expect, how each stage is managed, and what you can do to slow progression and protect your health.
What is chronic kidney disease (CKD)?
Chronic kidney disease is a long-term loss of kidney function that worsens over time. Unlike acute kidney injury—which can happen suddenly due to infection or dehydration—CKD progresses slowly and often silently.
Major causes include:
- Diabetes (the leading cause)
- High blood pressure
- Glomerulonephritis (inflammation of kidney filters)
- Polycystic kidney disease (genetic)
- Repeated kidney infections or damage
How many stages of kidney disease are there?
Doctors classify CKD into 5 stages, based on GFR:
Stage 1: Kidney damage with normal function
In stage 1, the GFR is 90 or higher, meaning kidney function is still normal. Most people don’t notice symptoms at this stage, and the disease is often found only through routine blood or urine tests. The main goal here is early detection and controlling conditions like diabetes and high blood pressure that can speed up damage.
Stage 2: Mild loss of function
Stage 2 occurs when GFR falls between 60 and 89. Kidney function is mildly reduced, but symptoms are usually minimal. Regular monitoring, healthy lifestyle changes, and avoiding kidney-harming medications help prevent further progression.
Stage 3: Moderate CKD
Stage 3, with GFR between 30 and 59, is when many people begin to notice changes. Fatigue, swelling in the legs, anemia, and high blood pressure are common. Doctors often recommend dietary changes, medications, and close follow-up with a kidney specialist.
Stage 4: Severe loss of function
In stage 4, GFR is between 15 and 29, showing severe kidney damage. Symptoms like nausea, bone pain, fluid retention, and reduced urine output are more pronounced. This stage is when patients and doctors begin preparing for dialysis or a kidney transplant.
Stage 5: Kidney failure (end-stage renal disease)
Stage 5, or end-stage renal disease, happens when GFR drops below 15. The kidneys can no longer support the body’s needs, leading to severe fatigue, swelling, appetite loss, and dangerous electrolyte imbalances. At this point, treatment usually requires dialysis or a kidney transplant, though some may choose palliative care.
Here’s a breakdown of symptoms and life expectancy at stage 2 kidney disease.
What is GFR and why does it matter?
- GFR (glomerular filtration rate) estimates how well your kidneys filter waste.
- Calculated using blood creatinine, age, sex, and sometimes race.
- A lower GFR = worse kidney function.
CKD staging is entirely based on GFR, which is why regular blood tests are essential.
Urine protein test strips can also help detect early kidney damage.
How fast does kidney disease progress?
Progression varies:
- Some people remain in stage 1–2 for years with good management.
- Others move quickly from stage 3 to stage 5, especially with uncontrolled diabetes or high blood pressure.
- Lifestyle, genetics, and treatment adherence all influence the speed.
Can early stages of kidney disease be reversed?
- Stage 1–2: Sometimes reversible if the cause is treated (e.g., controlling blood sugar, treating infections).
- Stage 3–4: Damage is usually permanent, but progression can be slowed.
- Stage 5: Requires dialysis or transplant—cannot be reversed.
Symptoms of kidney disease by stage
- Early stages (1–2): Usually no noticeable symptoms.
- Stage 3: Fatigue, swelling, high blood pressure, changes in urination.
- Stage 4: Nausea, poor appetite, sleep problems, bone pain.
- Stage 5: Severe fatigue, weakness, confusion, shortness of breath, itching.
How to prevent or slow CKD progression
- Control diabetes and blood pressure—the top causes of CKD.
- Eat a kidney-friendly diet: Low sodium, moderate protein, reduced processed foods.
- Stay hydrated (unless otherwise advised by your doctor).
- Avoid smoking and excessive alcohol.
- Get regular checkups with blood and urine tests.
- Manage medications carefully—some pain relievers (NSAIDs) can worsen kidney damage.
FAQs about CKD stages
- How many stages of kidney disease are there?
Five. Stages are based on GFR, ranging from stage 1 (mild) to stage 5 (kidney failure). - What stage of kidney disease requires dialysis?
Usually stage 5, though some stage 4 patients may need it if symptoms are severe. - Can you feel kidney disease in early stages?
Not usually. That’s why regular testing is important if you’re at risk. - Can CKD be cured?
No cure, but progression can be slowed or managed. Stage 1–2 may be reversible if the cause is addressed. - What’s the life expectancy with kidney disease?
It depends on stage, age, and overall health. Early detection and treatment greatly improve outlook.
Final thoughts
So, how many stages of kidney disease are there? The answer is: five. Each stage reflects how well your kidneys filter waste, measured by GFR. The earlier kidney disease is detected, the more can be done to slow its progression.
If you have diabetes, high blood pressure, or a family history of kidney disease, regular testing is essential—even if you feel fine.
Ribbon Checkup offers at-home kidney and metabolic health tests that give you lab-quality insights so you can monitor your health and take action early.
References
- Centers for Disease Control and Prevention (CDC). (2023). Chronic Kidney Disease in the United States.
- National Kidney Foundation. (2023). Stages of CKD.
- Mayo Clinic. (2023). Chronic kidney disease.
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (2024). CKD fact sheet.
- World Health Organization. (2022). Chronic kidney disease global data.