Clinical staging of chronic kidney disease

1. 1st phase

Glomerular filtration rate (GFR) is normal or elevated, GFR ≥ 90 ml/(min·1.73 m²).

Signs of kidney damage (such as abnormal blood or urine components or abnormal imaging tests) are present, but kidney function is basically normal.

Patients may not have obvious symptoms, but they need to be closely monitored and risk factors controlled.

2. 2nd phase

GFR decreased slightly, 60-89 ml/(min·1.73 m²).

As kidney damage persists, nonspecific symptoms such as mild fatigue and loss of appetite may begin to appear.

The focus of treatment is to control the primary disease, such as hypertension, diabetes, etc., and delay the progression of the disease.

3. 3rd phase

Stage 3a: GFR decreases slightly to moderately, 45-59 ml/(min·1.73 m²).

Stage 3b: GFR decreases moderately to severely, 30-44 ml/(min·1.73 m²).

Symptoms gradually become more obvious, and there may be anemia, abnormal bone metabolism, increased risk of cardiovascular disease, etc. Comprehensive treatment is required, including dietary adjustment, drug therapy, etc.

4. 4th phase

GFR is severely decreased, 15-29ml/(min·1.73m²).

Complications increase and become more severe, such as severe anemia, electrolyte imbalance, acid-base imbalance, etc. Renal replacement therapy may be required.

5. 5th issue

In the renal failure stage, GFR is less than 15 ml/(min·1.73m²) or dialysis treatment is required.

Systemic symptoms are obvious, such as nausea, vomiting, dyspnea, etc. Dialysis or kidney transplantation is usually required to maintain life.

The staging of chronic kidney disease helps doctors develop personalized treatment plans. Patients who understand the staging can also better cooperate with treatment and improve their quality of life.