Who´s At Risk
For Chronic
Kidney Disease

More than 10% of adults in the US have chronic kidney disease (CKD)—though most don’t realize it. One challenge in detecting CKD is that there are virtually no symptoms until later stages of the disease, when kidney damage has already occurred. Know your risk factors and get screened for CKD—especially if you have diabetes or high blood pressure.

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Stages of Chronic Kidney Disease

Chronic kidney disease (CKD) is divided into 5 stages based on the level of kidney function as measured by certain tests performed by your doctor. During the progression of CKD, kidneys slowly stop working the way that they should—usually over the course of many years. 

While there is no cure for CKD, there are treatments that can help—and many ways to make sure you’re managing your health appropriately and living well. With early diagnosis and treatment, you may be able to slow progression and keep your kidneys working longer.


Understanding the 5 stages of chronic kidney disease


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Early stage CKD

Kidney damage with normal kidney function, eGFR of 90–120

Treatment goals: 
  • Good management for any underlying conditions, including diabetes or high blood pressure
  • Get treatment for existing medical conditions
  • Slow the progression of CKD
  • Reduce the risk of complications


What you can do: 
  • See your doctor for tests and address any other health issues
  • Learn all you can about CKD
  • Make healthy lifestyle choices—quit smoking, exercise, eat well, reduce stress, get enough sleep
  • Take all medication exactly as prescribed
  • Talk to your doctor before using over-the-counter medications
  • Check out additional resources for CKD information
  • Get support from family, friends, your doctor and your counselor, if you have one

Early stage CKD

Kidney damage with mild loss of kidney function, eGFR of 60–89

Treatment goals: 
  • Good management for any underlying conditions, including diabetes or high blood pressure 
  • Get treatment for existing medical conditions
  • Slow the progression of CKD
  • Reduce the risk of complications

What you can do: 
  • See your doctor for tests and address any other health issues
  • Learn all you can about CKD
  • Make healthy lifestyle choices—quit smoking, exercise, eat well, reduce stress, get enough sleep
  • Take all medication exactly as prescribed
  • Talk to your doctor before using over-the-counter medications
  • Check out additional resources for CKD information
  • Get support from family, friends, your doctor and your counselor, if you have one

Early stage CKD

Kidney damage with moderate to severe loss of kidney function, eGFR of 30–59

Treatment goals: 
  • Evaluate your condition with your doctor and treat complications
  • Slow the progression of CKD by treating underlying conditions (high blood pressure, diabetes, etc.)
  • Modify your treatment for other conditions, per your doctor’s instruction

What you can do: 
  • See your doctor and discuss changes in your test results and any new or changing symptoms you may be experiencing
  • Ask your doctor or nurse about lifestyle changes, including diet modifications, that may help
  • Ask your doctor what steps to take if you have high blood pressure (hypertension), high blood sugar, high cholesterol or anemia 

TREATMENT: 
PLANNING AHEAD 

There are several options to consider for treating stage 5 CKD, also known as ESRD. Your doctor, family and social worker or counselor all want to see you thrive and they can help you decide which treatment best fits your life.
Learn about treatment options to consider

Late stage CKD

Severe loss of kidney function, eGFR of 15–29

Possible signs and symptoms: Complications such as anemia (low blood iron), high blood pressure and abnormal blood levels of phosphorus, calcium and vitamin D

Treatment goals: 
  • Control your blood pressure, blood sugar and cholesterol.
  • Prepare for stage 5, also called end stage renal disease (ESRD), by talking about treatment options.
  • Learn about the different ways to treat kidney failure.
  • Schedule a procedure to create your access site for dialysis, if appropriate. The access site is where the dialysis equipment will be connected to your bloodstream for hemodialysis or your belly (peritoneal cavity) for peritoneal dialysis.


What you can do: 
  • Stay in touch regularly with your treatment team, including your primary care physician, nephrologist, nurse practitioner and a counselor, if you have one.
  • Educate yourself and your family as thoroughly as possible about CKD. Learn about treatment options, and discuss them with your nephrologist to see what best fits your life. Taking a class on your treatment options can be especially helpful.
  • If your eGFR is 20 or above, talk to your nephrologist to see if a kidney transplant is a good treatment option for you.
  • Talk to your doctor about all of your dialysis options, including at-home dialysis treatments. Also ask your doctor for convenient dialysis center recommendations, and schedule a tour. Getting information and answers now will give you some time to get comfortable with your choices.
  • Talk to your doctor about placement for your access if you’re choosing to go on dialysis. Making this decision prior to kidney failure will give you more placement options. The “access site” is the location on your body where dialysis equipment can be connected to access your bloodstream for hemodialysis or access your belly for peritoneal dialysis.
  • Lean on your support network—they care about and want to be there for you as you adjust to the changes CKD brings. You may also want to find a support group of other people living with CKD. Ask your nurse for recommendations.

End stage renal disease

Kidney failure, eGFR of less than 15

End stage renal disease (ESRD) is the final stage of CKD and indicates that both kidneys are no longer working sufficiently to keep your body healthy and chemically balanced. If you haven’t already decided on an ESRD treatment with your doctor, it’s time to make the decision together.  

Possible signs and symptoms: Fatigue associated with anemia (low blood iron), decreased appetite, nausea, vomiting, abnormal lab values including elevated potassium, abnormalities in hormones related to bone health, elevated phosphorus and/or decreased calcium, high blood pressure, swelling in hands/legs/eyes/lower back (sacrum) and shortness of breath


Treatment goals: 



What you can do: 
  • Follow your kidney treatment exactly as prescribed, including receiving dialysis for the full recommended time and/or taking your medications.
  • Get to know your treatment team at your kidney dialysis center or meet with your at-home dialysis treatment team, depending on which method of dialysis you’ve chosen.
  • Commit to being an active participant in your kidney care. Only you can ensure that you follow your care plan and take the necessary steps to live your fullest.
  • Get support and information from your social worker, as needed. He or she can provide advice and resources to help you adjust to living with ESRD—and thrive.
  • Find an in-person or online support group—your social worker can help you find one. Talking to people who are going through the same things you are can really help.