Chronic kidney disease is divided into 5 stages. Which stage are you in? Early detection and early treatment!

In the field of chronic diseases, chronic kidney disease has gradually become a major hidden danger threatening people's health. Many people have a vague understanding of chronic kidney disease, and even do not notice it until the disease develops to a more serious stage. It is very important for patients to understand the staging of chronic kidney disease. It can not only help patients clearly understand their condition, but also provide a strong basis for early detection and early treatment.

Chronic kidney disease staging

The staging of chronic kidney disease (CKD) is mainly based on the glomerular filtration rate (GFR), which reflects the kidney's ability to filter waste and excess water from the blood. The lower the GFR value, the more severe the kidney function is impaired. In addition, proteinuria, kidney morphology and other related indicators will be combined to assist in the judgment. Proteinuria is an important sign of kidney damage. If a large amount of protein appears in the urine, it means that the glomerular filtration barrier may have been damaged.

The 5 stages of chronic kidney disease

1. Stage 1 : Normal or elevated renal function, accompanied by other indicators of renal damage : At this stage, GFR ≥ 90 ml/min/1.73 m². Although renal function appears normal or even elevated, other indicators of renal damage such as proteinuria, hematuria, and abnormal renal structure have already appeared. Most patients do not have obvious symptoms at this stage, and they are easily overlooked. However, some clues can be found through urine routine tests, renal function tests, and other items in physical examinations. For example, the presence of microalbuminuria in urine routine tests reminds patients to pay attention to kidney health, adjust their lifestyles, and actively control possible risk factors, such as hypertension and diabetes, to prevent further progression of the disease.

2. Stage 2 : Mild decline in renal function : At this time, GFR is between 60 - 89ml/min/1.73m², and renal function has already declined slightly. The patient may still not feel obvious discomfort, and only a few people will feel mild symptoms such as fatigue and backache. However, these subtle manifestations can easily be ignored as daily fatigue. At this stage, it is particularly important to regularly check renal function and monitor blood pressure, blood sugar and other indicators. If the patient has underlying diseases, such as hypertension and diabetes, the condition must be strictly controlled, and medication should be taken on time as prescribed by the doctor to avoid further damage to the kidneys.

3. Stage 3 : Moderate decline in renal function : Stage 3 is further divided into stage 3a (GFR 45 - 59ml/min/1.73m²) and stage 3b (GFR 30 - 44ml/min/1.73m²). As GFR decreases further, patients will experience more obvious symptoms, such as increased nocturia, edema (mostly starting from the eyelids and lower limbs), pale complexion and fatigue caused by anemia. Due to the decreased ability of the kidneys to regulate water and electrolytes, patients may also experience electrolyte disorders, such as hyperkalemia and hypocalcemia, which in turn lead to arrhythmias, muscle cramps and other problems. At this time, patients need to actively cooperate with treatment, adjust their diet structure, limit the intake of protein, salt and phosphorus, and may need to use drugs to correct anemia, control blood pressure and regulate electrolyte balance.

4. Stage 4 : Severe decline in renal function : GFR is between 15 - 29ml/min/1.73m², and renal function is severely impaired. The patient's symptoms will become more severe, edema will intensify, and pleural effusion and ascites may occur, leading to discomfort such as dyspnea and abdominal distension. Anemia symptoms will worsen, physical fatigue will be obvious, and the quality of life will be greatly affected. In addition, the risk of cardiovascular diseases such as hypertension and coronary heart disease will also increase significantly. At this stage, in addition to continuing to strictly control diet and drug treatment, patients also need to prepare for renal replacement therapy (such as dialysis or kidney transplantation) in advance, understand relevant knowledge and procedures, and find appropriate treatment resources.

5. Stage 5 : Renal failure: also known as end-stage renal disease (ESRD), GFR < 15ml/min/1.73m² or dialysis treatment has begun. At this point, the kidneys have basically lost their function, and metabolic waste and excess water in the body cannot be discharged normally, seriously affecting the normal operation of various systems in the body. Patients need to rely on dialysis (hemodialysis or peritoneal dialysis) to maintain life. Dialysis can replace some of the functions of the kidneys and remove toxins and excess water from the body. For patients who can afford it, kidney transplantation is a better choice, but kidney transplantation faces problems such as donor shortage and postoperative immune rejection.

The staging of chronic kidney disease is a gradual process, and early detection and active intervention are crucial. For people with high-risk factors such as hypertension, diabetes, obesity, and those with kidney disease in their family, regular physical examinations and attention to kidney health are even more important. Once abnormalities are found, they should seek medical attention in a timely manner and follow the doctor's advice for treatment and management to delay the progression of the disease and improve the quality of life.