It is estimated that kidney disease affects 31 million people in the Inida alone, and globally 1 in 10 people have some form of kidney disease. Also called renal disease, kidney disease is the general term for damage that reduces the function of the kidney. Chronic kidney disease (CKD) occurs when kidneys are no longer able to clean toxins and waste product from the blood and perform their functions to full capacity. This can happen all of a sudden or over time.1 Chronic kidney disease (CKD) has five distinct stages.
Every day, our two kidneys filter about 120 to 150 quarts of Kidneys Blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid.2 Healthy kidneys help regulate blood pressure, remove waste and water, signal your body to make red blood cells, and help regulate growth in children.
How are the 5 Stages of kidney failure determined?
The first thing to understand is how the stages of renal disease are determined. The health of your kidneys is measured primarily by your estimated glomerular filtration rate (eGFR). GFR is the rate at which fluid is filtered through the kidneys. A higher filtration rate indicates a healthy kidney; a lower rate indicates reduced or suboptimal kidney function, whether due to injury or disease.
Your kidneys’ filtration rates are estimated by the amount of creatinine in your bloodstream. Creatinine is a waste product of the body’s metabolism of creatine phosphate, a crystalline compound created by everyday muscle movement. The kidneys filter creatinine out of the bloodstream. A serum test will show how much creatinine is in your blood. The higher the level of creatinine, the less of it your kidneys are filtering out. This test is key to estimating your kidney function level.
What is a glomerular filtration rate test?
Your kidneys are your body’s main filtration system. They remove waste products from your blood and excrete them via your urine. Glomeruli are the small filters inside your kidneys. If your kidneys aren’t working properly, your glomeruli won’t filter as efficiently. Your doctor may order a glomerular filtration rate (GFR) test if they suspect your kidneys aren’t working properly. This is a simple blood test.
5 stages of Kidney Failure
In Chronic Kidney Disease Stage 1, your eGFR is 90 or above, meaning that your kidneys are functioning at 90% or better. Your filtration rate is normal, but there might be other indications that not all is well with your kidneys, such as the presence of proteins in your urine. Typically, there are no symptoms when kidneys function at 90 % or better.
You can slow disease progression by taking these steps:
- Work at managing blood sugar levels if you have diabetes.
- Follow your doctor’s advice for lowering blood pressure if you have hypertension.
- Maintain a healthy, balanced diet.
- Don’t use tobacco.
- Engage in physical activity for 30 minutes a day, at least 5 days a week.
- Try to maintain an appropriate weight for your body.
Stage 2 CKD means you have mild kidney damage and an eGFR between 60 and 89. Most of the time and eGFR between 60 and 89 means your kidneys are healthy and working well. But if you have Stage 2 kidney disease, this means you have other signs of kidney damage even though your eGFR is normal. Signs of kidney damage could be protein in your urine (pee) or physical damage to your kidneys. The general symptoms are fatigue, itching, loss of appetite, sleep problems, weakness
It’s time to develop a relationship with a kidney specialist. There’s no cure for CKD, but early treatment can slow or stop the progression. It’s important to address the underlying cause. If you have diabetes, high blood pressure, or heart disease, follow your doctor’s instructions for managing these conditions. It’s also important to maintain a good diet, get regular exercise, and manage your weight. If you smoke, ask your doctor about smoking cessation programs.
In Stage 3, your eGFR is between 30 and 59. At this stage, kidney disease can be identified with only a blood test. Stage 3 is often broken down into two phases: Stage 3a (early), during which your eGFR is between 45 and 59, and Stage 3b (late), during which your eGFR is between 30 and 44. During Stage 3, you may or may not be symptomatic. If symptoms do appear, they are more likely to do so during Stage 3b, and may include:
- back pain
- swollen hands and/or feet
- unusually frequent or infrequent urination
- loss of appetite
- persistent itching
- sleep problems
- swelling of the hands and feet
- urinating more or less than usual
It’s important to manage underlying conditions to help preserve kidney function. This may include:
- High blood pressure medications such as angiotensin-converting enzyme inhibitors or angiotensin ii receptor blockers
- Diuretics and a low salt diet to relieve fluid retention
- Cholesterol-lowering medications
- Erythropoietin supplements for anaemia
- Vitamin D supplements to address weakening bones
- Phosphate binders to prevent calcification in the blood vessels
- Following a lower protein diet so your kidneys don’t have to work as hard
As patients enter CKD Stage 4, they may begin feeling unwell and show noticeable jaundice. Stage 4 of CKD is the last stage before kidney failure. Doctors begin discussing kidney replacement options for on-going dialysis and possible transplantation. As patients enter CKD Stage 4, they may begin feeling unwell and show noticeable jaundice. Stage 4 of CKD is the last stage before kidney failure. Doctors begin discussing kidney replacement options for on-going dialysis and possible transplantation.
The basic symptoms of stage 4 would be
- Back pain
- Chest pain
- Decreased mental sharpness
- Loss of appetite
- Muscle twitches or cramps
- Nausea and vomiting
- Persistent itching
- Shortness of breath
- Sleep problems
- Swelling of the hands and feet
- Urinating more or less than usual
In stage 4, you’ll need to work very closely with your doctors. In addition to the same treatment as earlier stages, you should start discussions about dialysis and kidney transplant should your kidneys fail. These procedures take careful organization and a lot of time, so it’s wise to have a plan in place now.
People with a GFR less 15 begin on-going dialysis treatments or make the decision to receive medical care without dialysis for the remainder of their life. People who qualify for a kidney transplant continue on dialysis until a matching donor is identified and surgery can be scheduled. Stage 5 is the point at which you must either begin dialysis or receive a kidney transplant. This is not a time for despair, and you are not alone on this journey. Some symptoms of kidney failure include those associated with Stage 3 (see above), and also:
- Diminished appetite
- Muscle cramps
- Disturbed sleep
- Breathing trouble
- Nausea and vomiting
Once you have complete kidney failure, life expectancy is only a few months without dialysis or a kidney transplant. Dialysis isn’t a cure for kidney disease, but a process to remove waste and fluid from your blood. There are two types of dialysis, hemodialysis and peritoneal dialysis.
Don’t let Chronic Kidney Disease sneak up on someone you love. Ask for a GFR test at your next wellness checkup. If you have a kidney , at any stage, learn about ways to lead a longer, healthier life. Medisys Hospitals is the best Kidney Hospital and we have an expert medical team who will help you with all your kidney-related problems. Live a healthy life.