Chronic kidney disease (CKD) refers to all five stages of kidney damage, from very mild damage in stage 1 to complete kidney failure in stage 5.

The stages of kidney disease are based on how well the kidneys can filter waste and extra fluid out of the blood. In the early stages, the kidneys can still filter waste effectively. In the later stages, they must work harder to get rid of waste and may stop working altogether.

Doctors measure how well your kidneys function by measuring the estimated glomerular filtration rate, or eGFR. Your eGFR is a number based on a test for creatinine, a waste product in your blood.
The stages of kidney disease are based on the eGFR number.

Stage 1 CKD

Stage 1 CKD means you have mild kidney damage and an eGFR of 90 or greater.
Most of the time, an eGFR of 90 or greater means your kidneys are healthy and working well, but you have other signs of kidney damage. 
These signs could be protein in your urine (pee) or physical damage to your kidneys. Here are some ways to help slow the damage to your kidneys in Stage 1:

  • Control your blood sugar if you have diabetes.
  • Control your blood pressure.
  • Eat a healthy diet.
  • Don’t smoke or use tobacco.
  • Be active for 30 minutes a day, five days a week.
  • Stay at a healthy weight.
  • Ask your doctor if there are medicines you can take to help protect your kidneys.
  • Make an appointment to see a nephrologist (kidney doctor), even if you already have a primary care doctor.

Stage 2 CKD

Stage 2 CKD means you have mild kidney damage and an eGFR between 60 and 89.
Most of the time, an 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, such as protein in your urine (pee) or physical damage to your kidneys. 
Here are some ways to help slow the damage to your kidneys in Stage 2:

  • Control your blood sugar if you have diabetes.
  • Control your blood pressure.
  • Eat a healthy diet.
  • Don’t smoke or use tobacco.
  • Be active for 30 minutes a day, five days a week.
  • Stay at a healthy weight.
  • Ask your doctor if there are medicines to protect your kidneys.
  • Make an appointment to see a nephrologist (kidney doctor), even if you already have a primary care doctor.

Stage 3 CKD

Stage 3 CKD means you have an eGFR between 30 and 59, indicating there is some damage to your kidneys and they aren’t working as well as they should. 

Stage 3 is separated into two stages: 

  • Stage 3a means you have an eGFR between 45 and 59.
  • Stage 3b means you have an eGFR between 30 and 44.

Many people with Stage 3 kidney disease have no symptoms. But if there are symptoms, they may be:

  • Swelling in your hands and feet
  • Back pain
  • Urinating (peeing) more or less than normal
  • At this stage, waste builds up in your body and your kidneys are not working well. You’re also more likely to have health complications such as:
  • High blood pressure
  • Anemia (a low number of red blood cells)
  • Bone disease


To keep your Stage 3 kidney disease from getting worse, you can:

  • Control your blood sugar if you have diabetes.
  • Control your blood pressure.
  • Don’t smoke or use tobacco.
  • Eat a healthy diet. 
  • Be active for 30 minutes a day, five days a week.
  • Stay at a healthy weight.
  • Visit a nephrologist (kidney doctor), who will make a treatment plan that is right for you and tell you how often you will need to have your kidneys checked.
  • Meet with a dietitian, who will help you follow a healthy diet. 
  • Ask your kidney doctor about blood pressure medicines called ACE inhibitors and ARBs if you have diabetes or high blood pressure. Sometimes these medicines can help keep kidney disease from getting worse.

Stage 4 CKD

Stage 4 CKD means you have an eGFR between 15 and 29, indicating your kidneys are moderately or severely damaged and are not working as they should. 
Stage 4 kidney disease should be taken very seriously – it’s the last stage before kidney failure.

At Stage 4, many people have symptoms such as:

  • Swelling in the hands and feet
  • Back pain
  • Urinating (peeing) more or less than normal
  • In this stage, waste builds up in your body and your kidneys are not working well. You’ll likely also have health complications such as:
  • High blood pressure 
  • Anemia (a low number of red blood cells)
  • Bone disease


To keep kidney disease from getting worse at this stage, your doctor will recommend that you:

  • Attend regular appointments with a nephrologist (kidney doctor), who will make a treatment plan that is right for you and tell you how often you will need to have your kidneys checked.
  • Meet with a renal dietitian, who will help you follow a healthy diet. 
  • Take special blood pressure medicines like ACE inhibitors and ARBs if your doctor recommends them. If you have diabetes or high blood pressure, sometimes these medicines can help keep kidney disease from getting worse.

Stage 4 is the time to start talking with your nephrologist about how to prepare for kidney failure. Once your kidneys have failed, you’ll need to start dialysis or have a kidney transplant to live.

Preparing for dialysis: Dialysis helps clean your blood when your kidneys can no longer function. There are several things to think about, such as the type of dialysis, how to plan your treatments, and how they will affect your daily life. Learn more about hemodialysis and peritoneal dialysis.

Preparing for a transplant: A kidney transplant is surgery to remove your failed kidney and replace it with a healthy kidney from someone else’s body. If you can find a living kidney donor, you may not need to start dialysis at all. It’s possible to have a transplant when your kidneys are getting close to failure. Learn more about kidney transplants.

Stage 5 CKD

Stage 5 CKD means you have an eGFR of less than 15, which indicates that the kidneys are getting very close to failure or have completely failed. If your kidneys fail, waste builds up in your blood, which makes you very sick.
Some of the symptoms of kidney failure are:

  • Itching
  • Muscle cramps
  • Feeling sick and throwing up
  • Not feeling hungry
  • Swelling in your hands and feet
  • Back pain
  • Urinating (peeing) more or less than normal
  • Trouble breathing
  • Trouble sleeping


Once your kidneys have failed, you’ll need to start dialysis or have a kidney transplant to live.

Preparing for dialysis 

Dialysis helps clean your blood when your kidneys have failed. There are several things to think about, such as the type of dialysis, how to plan your treatments, and how they will affect your daily life. Learn more about hemodialysis and peritoneal dialysis.

Preparing for a transplant

A kidney transplant is surgery to remove your failed kidney and replace it with a healthy kidney from someone else’s body. If you can find a living kidney donor, you may not need to start dialysis at all. It’s possible to have a transplant when your kidneys are getting close to failure. Learn more about kidney transplants.


Acting early is one of the most important things you can do if you think you’re at risk of CKD. Symptoms of early-stage kidney disease are mild and can be easily overlooked. That’s why it’s essential to have regular checkups if you have diabetes or high blood pressure, the two leading causes of kidney disease. Early diagnosis and management of coexisting conditions can help slow or prevent progression.