Stages of Kidney Disease

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 percent 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 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

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