Stages of Chronic Kidney Disease

Stages of Chronic Kidney Disease

Chronic Kidney Disease (CKD) is a when you have a loss of kidney function or kidney damage, for three months or more. The amount of damage to your kidneys is categorized by five stages.

People with any stage of kidney disease are encouraged to:

  • Be physically active
  • Stop smoking
  • Limit alcohol intake
  • Take medications as prescribed
  • Aim for a healthy weight
  • Avoid anti-inflammatory pain medications e.g. ibuprofen, naproxen, high-dose ASA (more than 325 mg per day)
  • Maintain good blood pressure
  • If you have diabetes maintain good blood sugar
  • Adopter un style de vie sain : saine alimentation, activité physique, abandon du tabac, consommation d’alcool limitée.
  • Respecter la posologie de vos médicaments.
  • Viser un poids santé.
  • Éviter de prendre des anti-inflammatoires comme l’ibuprofène, le naproxène, des doses élevées d’aspirine (plus de 325 mg par jour).
  • Stabiliser votre tension artérielle (moins de 130/80).
  • Si vous avez le diabète, maintenir un bon taux de sucre sanguin, soit un taux d’HbA1c inférieur à 7 % (analyse sanguine en laboratoire).

Additionally, those with Stage 4 CKD should:

  • Adhere to a prescribed kidney friendly diet and their treatment plan
  • Comme ci-dessus.
  • Observer un régime alimentaire prescrit bon pour les reins.

Those with Stage 5 CKD may need to start kidney replacement therapy which can include:

What’s happening?

  • The kidneys are still working normally.
  • Creatinine clearance is at a normal or high level greater than 90 ml/min.
  • There are usually no symptoms to indicate the kidneys are damaged.
  • Because kidneys do a good job even when they’re not functioning at 100%, most people will not know they have Stage 1 CKD.

People are usually diagnosed with Stage 1 because they were being tested for another condition such as diabetes or high blood pressure (the two leading causes of kidney disease).

Other ways a person may discover they are in Stage 1 CKD:

  • Higher than normal levels of creatinine or urea in the blood
  • Blood or protein in the urine
  • Kidney damage seen on an ultrasound, MRI, CT scan or contrast X-ray

What now?

  • Regular testing for protein in the urine and serum creatinine will show if the kidney damage is progressing.
  • The goal in Stage 1 is to stop the progress or to slow down the progression of kidney disease.
  • In many cases, making healthy lifestyle changes and following your treatment plan, can help keep your kidneys healthy longer.

What’s happening?

  • There is damage to the kidneys
  • There is a decrease in kidney function measured by Creatinine Clearance or eGFR
  • Waste products build up in the blood causing a condition known as uremia

Complications of kidney disease such as high blood pressure, anemia and early bone disease may happen.

Symptoms that you may have:

Fatigue:

  • Feeling tired is common and is often caused by anemia.

Swelling (Edema):

  • The kidneys may not be able to balance water in the bodyToo much fluid (water) may build in the lower legs, hands, abdomen, face and lungs.
  • Fluid in the lungs can cause shortness of breath.

Changes in Urine & Urinary frequency:

  • Urine may be foamy if there is protein in it, or dark orange, brown, tea coloured or red if it contains blood.
  • Noticeable changes in urinary frequency and amount (Peeing more often but in smaller amounts).

Kidney pain:

  • Kidney pain may happen with some kinds of kidney problems (polycystic kidney disease or infections).
  • This pain can be felt in the back where the kidneys are located.

Sleep problems:

  • Trouble falling asleep or staying asleep may happen.
  • Itching, muscle cramps or restless legs or peeing often at night may be some causes of poor sleep.

The goals in Stage 2 and 3 are to:

  • Keep the kidneys working as well as possible
  • Slow the progression of kidney disease
  • Treat the symptoms of kidney disease

What’s happening?

  • There is advanced kidney damage
  • There is a severe decrease in kidney function measured by Creatinine Clearance or eGFRº (See staging chart)
  • A person will develop complications of kidney disease such as high blood pressure, anemia, bone disease, heart disease and other cardiovascular diseases.
  • It is likely someone with Stage 4 and 5 CKD will need dialysis or a kidney transplant in the future.

Symptoms that are experienced in Stage 4/5 include:

Swelling (Edema):

  • The kidneys may not be able to balance water in the body
  • Too much fluid (water) may build in the lower legs, hands, abdomen, face and lungs.
  • Fluid in the lungs can cause shortness of breath.

Changes in Urine & Urinary frequency:

  • Urine may be foamy if there is protein in it, or dark orange, brown, tea coloured or red if it contains blood.
  • Noticeable changes in urinary frequency and amount (Peeing more often but in smaller amounts).

Kidney pain:

  • Kidney pain may happen with some kinds of kidney problems, (polycystic kidney disease or infections).
  • This pain can be felt in the back where the kidneys are located.

Sleep problems:

  • Trouble falling asleep or staying asleep may happen
  • Itching, muscle cramps or restless legs or peeing often at night may be some causes of poor sleep.

Loss of appetite:

  • Not feeling hungry may happen as waste products build up in the body
  • Weight loss may occur

Nausea and Vomiting:

  • Feeling sick to the stomach may happen as waste products build up in the body (may cause gagging or throwing up)
  • May result in loss of appetite and/or weight loss

Changes in Taste:

  • Food may not taste the same as before
  • Food may have a metallic (like metal) taste
  • May result in loss of appetite and/or weight loss

Uremic breath:

  • Bad (sour) breath may happen as waste products builds up in the blood

Confusion:

  • Difficulty thinking clearly may happen as waste products build up in the blood, (making simple mistakes, forgetting).

The goals in Stage 4 and 5 are to:

  • Manage the complications of kidney disease
  • Prepare for dialysis or transplant
  • Provide comfort measures if choice is not to have dialysis or transplant.