CKD Stages Explained: A Visual Guide
Chronic kidney disease (CKD) is classified into 5 stages based on your eGFR number. Click on any stage to learn what it means, what to expect, and what steps to take.
Normal or High
eGFR: ≥90 mL/min/1.73m²Kidney damage with normal or high kidney function. At this stage, kidneys are still working well but there may be signs of damage (protein in urine, structural abnormalities, or genetic diagnosis).
What This Means
Most people at this stage feel completely normal. Kidney damage may only be detectable through lab tests. The focus is on identifying and treating the underlying cause.
What To Do at This Stage
- Identify and treat the underlying cause (diabetes, high BP)
- Control blood pressure (<130/80 mmHg)
- Stay active and maintain a healthy weight
- Get annual kidney function checks
- Avoid NSAIDs and other kidney-toxic medications
Mildly Decreased
eGFR: 60–89 mL/min/1.73m²Mild decrease in kidney function. This is very common, especially in older adults, and may not require treatment on its own unless other signs of kidney damage are present.
What This Means
Your kidneys are still working well enough that you likely don't notice any symptoms. Many people over 60 have an eGFR in this range naturally. It becomes more significant if you also have protein in your urine or other risk factors.
What To Do at This Stage
- Monitor kidney function every 6-12 months
- Control blood pressure and blood sugar
- Maintain a heart-healthy diet
- Exercise regularly
- Stay well-hydrated
Mild to Moderate Decrease
eGFR: 45–59 mL/min/1.73m²Mild to moderate decrease. This is where CKD starts to require more attention. Lifestyle changes and medication management can significantly slow progression.
What This Means
Your kidneys are working at roughly half capacity. You may still feel fine, but this is the critical stage for intervention. The right steps now can prevent or significantly delay progression to more serious stages.
What To Do at This Stage
- See your doctor regularly (every 3-6 months)
- Ask about ACE inhibitors or ARBs
- Follow a moderate-protein, low-sodium diet
- Avoid NSAIDs completely
- Get a referral to a nephrologist if not already seeing one
Moderate to Severe Decrease
eGFR: 30–44 mL/min/1.73m²Moderate to severe decrease. Higher risk of complications. Closer medical monitoring and dietary modifications are important.
What This Means
At this stage, you may begin to notice some symptoms like fatigue, changes in urination, or swelling. Complications like anemia, bone disease, and fluid imbalances become more common and need active management.
What To Do at This Stage
- See a nephrologist regularly
- Diet: restrict potassium, phosphorus, and sodium
- Monitor for anemia and bone mineral disease
- Review ALL medications with your care team
- Get labs checked every 3 months
Severely Decreased
eGFR: 15–29 mL/min/1.73m²Severe decrease in kidney function. Symptoms are common. Preparation for kidney replacement therapy (dialysis or transplant) may begin.
What This Means
Your kidneys are working at a significantly reduced level. Symptoms are likely present: fatigue, nausea, swelling, changes in appetite. This stage requires close medical management and planning for potential future treatments.
What To Do at This Stage
- Work closely with your nephrologist
- Discuss dialysis options and transplant evaluation
- Follow strict dietary restrictions
- Monitor fluid intake
- Consider vascular access surgery planning for dialysis
- Emotional support and education about treatment options
Kidney Failure
eGFR: <15 mL/min/1.73m²Kidney failure. Kidneys can no longer adequately filter waste from the blood. Dialysis or kidney transplant is needed to sustain life.
What This Means
At this stage, kidneys have lost nearly all their filtering ability. Without treatment (dialysis or transplant), waste products build up to dangerous levels. Many patients at this stage are on or preparing for dialysis.
What To Do at This Stage
- Begin or continue dialysis treatment
- Get on the transplant waiting list if eligible
- Strict dietary and fluid management
- Regular monitoring and all prescribed medications
- Connect with support groups and resources