Hello, welcome to chronic kidney disease program at University of California San Diego my name is Danita Trzebinksa and I’m a nephrologist in our clinic in this module we are going to talk about the different stages of chronic kidney disease chronic kidney disease is quite common it affects 11% of u.s. population which translates to about 30 million people another 30 million people are at risk for developing CKD at some point in their lives ideally.
We would like to prevent individuals from developing CKD in the first place but unfortunately, that is not always possible early detection is the second-best option in order to take appropriate actions to slow down the decline of kidney function let’s talk about estimating kidney function it’s usually not as precise or easy as checking your weight or even measuring electrolyte levels in your blood doctors nurses pharmacists use special equations to estimate kidney function based on the level of creatinine in the blood what is creatinine well creatinine is a waste product generated by muscle metabolism and removed or excreted.
If you will from the body by kidneys the higher the creatinine level in the blood the less efficient kidneys are at removing it from the body so the worse the level of kidney function is the term for the level of kidney function is glomerular filtration rate or GFR GFR is the rate at which kidneys filter toxins from the blood this number also correlates with overall kidney function we stage kidney disease or assign severity based on the GFR it is extremely important that you know your GFR in simple terms you can think of GFR as a percentage of normal kidney function, for example, GFR 40 means that your overall kidney function yes for both kidneys is about 40 per cent of normal please remember.
It is just an estimate and not a true measure of your kidney function also you need to realize that GFR fluctuates from day to day just like your blood pressure does or the stock market does so we look at the trend and not necessarily every individual value will now go over stages of chronic kidney disease there are five of them with one being the least severe and five being the most severe in stage one chronic kidney disease GFR is relatively preserved greater than ninety so it’s considered normal or close to normal yet there are some other markers of kidney disease, for example, there’s a protein in the urine and we’ll talk more about this a little bit later so that’s stage one chronic kidney disease in stage two CKD GFR is mildly reduced to between 60 and 89 and there are some other markers of kidney injury.
Most of the time it’s protein again you will see that protein is important now stage 3 this is the middle route kidney disease and also the most common category GFR in CKD three is moderately reduced is between 30 and 59 so not normal but not so bad at this stage you may begin to see complications of chronic kidney disease now let’s move to stage four in stage four CKD GFR is between 15 and 29 this is considered a pretty advanced stage so we start talking about what the kidney’s future might halt we might discuss potential plans for either dialysis or transplantation or above whatever is most appropriate for you in stage 5 GFR is less than 15 being in stage 5 does not automatically mean that you need to start dialysis.
Some patients can remain stage 5 for quite a few years without requiring dialysis, in general, we do not start patients on dialysis even one day sooner then it is necessary and most of the time patients tell me when it is necessary they feel it they can tell it is important to realize that dialysis is just a tip of the iceberg chronic kidney disease is a prevalent yet silent disease most patients do not know that they have it since CKD is not associated with clear symptoms till the disease is quite advanced therefore it is important to screen patients at increased risk for developing chronic kidney disease.
Let’s do two questions to test your understanding of this module the first question is what is GFR that’s an easy one and the answer is GFR is a glomerular filtration rate which is the rate at which the kidneys filter toxins from the blood and it is an estimation of overall kidney function what is the most common stage of chronic kidney disease remember there are five stages of chronic kidney disease and the question is which one is most common the correct answer is stage 3 is the most common age of chronic kidney disease congratulations at this point you have completed the module on the stages of chronic kidney disease please check our website for additional educational modules on kidney health