The pooled prevalence of Chronic kidney disease (CKD) in India is 13.24%, slightly higher among men (14.80%) compared to women (13.51%). Rural areas report higher rates (15.34%) than urban areas (10.65%). CKD prevalence has risen from 11.2% (2011–2017) to 16.38% (2018–2023).
India accounts for 33% of global CKD cases, highlighting its significant contribution to the worldwide burden, which makes early detection and management of chronic kidney disease stages significant to patient’s health.
Body’s overall health depends heavily on your kidneys, but their function can decline gradually without any noticeable symptoms. Healthcare providers measure kidney function through a specific scale called the estimated glomerular filtration rate (eGFR) that helps determine the disease stage. The scale ranges from stage 1 with mild damage to stage 5 that indicates complete kidney failure.
Understanding your risk factors and each stage can help you manage your kidney health better, especially since diabetes and high blood pressure cause all but one of these cases in adults.
Understanding the 5 Stages of Chronic Kidney Disease
Your kidneys take months or even years to show signs of chronic kidney disease. That’s why it’s vital to understand how doctors track and classify different stages to plan your treatment.
How kidney function is measured
Doctors rely on two main tests to check your kidney health and figure out your CKD stage. A blood test measures your creatinine and then calculates an estimated glomerular filtration rate (eGFR). This shows how well your kidneys clean waste from your blood. They also use a urine test called urine albumin-to-creatinine ratio (uACR) that looks for protein leakage—a sign your kidneys might be damaged.
Your doctor needs to repeat these tests for at least three months. This helps confirm if your kidney damage is permanent rather than temporary. They calculate your eGFR using a formula that looks at your age, sex, and creatinine levels. Creatinine is a waste product from your muscles that healthy kidneys normally filter out.
The GFR scale explained
The glomerular filtration rate shows how many milliliters of blood your kidneys clean each minute. Your kidneys work at 100% capacity when your GFR hits around 100 ml/min/1.73m². Numbers as low as 60 can still be normal if there’s no other sign of kidney damage.
The five stages of CKD based on eGFR values are:
- Stage 1: eGFR 90 or above with signs of kidney damage (90-100% function)
- Stage 2: eGFR 60-89 (60-89% function)
- Stage 3a: eGFR 45-59 (45-59% function)
- Stage 3b: eGFR 30-44 (30-44% function)
- Stage 4: eGFR 15-29 (15-29% function)
- Stage 5: eGFR less than 15 (less than 15% function)
What happens to your kidneys at each stage
It’s worth mentioning that doctors also look at your uACR results to stage CKD. Higher protein levels in your urine (albuminuria) point to more serious kidney damage and might change your treatment plan.
Early Stage CKD: Recognizing and Managing Stages 1-2
Your body may not give early warning signs when your kidneys start having problems. Most people don’t know they have chronic kidney disease until blood tests reveal it. Early diagnosis and quick action can slow down kidney damage.
Common symptoms and warning signs
Your body adapts well in the beginning stages of chronic kidney disease. This makes kidney disease asymptomatic in most patients. About 10% of adults in industrialized countries have CKD. Most cases show no symptoms at first. You might notice these subtle changes:
- Foamy or bubbly urine that suggests protein leakage
- Mild swelling around your ankles
- Light tiredness or weakness
- Skin that itches now and then
- Night-time bathroom trips become more frequent
Protein (albumin) in your urine often shows up as the first sign of kidney damage. This can happen even when your kidneys work normally with regards to cleaning waste products. Testing is the only reliable way to identify kidney disease in these early stages.
Lifestyle changes that make a difference
A few key changes in your daily routine can protect your kidneys after an early-stage CKD diagnosis:
Keep your blood pressure under 130/80. This matters most. People with diabetes should watch their blood sugar levels closely because stable readings reduce kidney damage risk by a lot.
Cut back salt to less than 5g each day – that’s about one teaspoon. This helps control fluid buildup. A balanced diet keeps your kidneys from working too hard.
Exercise for at least 150 minutes every week. This helps control blood pressure and weight. Stay away from over-the-counter NSAIDs like ibuprofen. These medicines can hurt your kidneys.
Working with your doctor on a monitoring plan
Start by creating a regular testing schedule with your healthcare provider. Yearly tests become vital if you have risk factors like diabetes, high blood pressure, or kidney disease in your family.
Your monitoring should include regular blood tests for estimated GFR and urine tests for albumin. These results help track your kidney’s health over time.
Talk to your doctor about ACE inhibitors or ARBs. These medicines can protect your kidneys while managing blood pressure. A kidney specialist (nephrologist) can create an individual-specific treatment plan that works best for you.
Middle Stage CKD: Critical Care During Stage 3
Stage 3 chronic kidney disease is a vital point in your kidney health experience. You’ll need more intensive management strategies to prevent your kidney function from declining further.
Why stage 3 is a turning point
Your kidneys show moderate damage at stage 3, with glomerular filtration rate (GFR) between 30-59 ml/min. This stage splits into stage 3a (GFR 45-59) and stage 3b (GFR 30-44). Most people first learn about their CKD diagnosis at this stage. The risk of complications goes up significantly, especially when moving from 3a to 3b. To name just one example, a 40-year-old with stage 3a can expect to live 24.5 years on average, nowhere near the 14.5 years for someone with stage 3b. Your kidneys have a harder time filtering waste at this point, which means toxins might build up.
Managing emerging symptoms
Some people don’t feel any different, but stage 3 usually brings noticeable kidney disease symptoms. You might deal with:
- Fatigue and weakness
- Swelling in hands, feet, or ankles
- Dry, itchy skin
- Back pain
- Sleep problems including muscle cramps or restless legs
- Changes in urination patterns
Your doctor might prescribe Angiotensin-Converting Enzyme (ACE) inhibitors or Angiotensin II Receptor Blockers (ARBs) to control blood pressure.(even without hypertension) because these medications help protect kidney function. On top of that, you might need medications for anemia, bone health, and cholesterol. Regular blood and urine tests become significant to track your kidney function closely.
Dietary adjustments to protect kidney function
Your dietary changes become more important as kidney function drops. Your doctor or renal dietitian will likely suggest:
- Keeping sodium under 2,300 mg daily
- Watching protein intake to reduce kidney strain
- Tracking potassium levels, especially if blood tests show high numbers
- Cutting back on phosphorus to maintain bone health and protect kidneys
- Limiting fluid intake if your healthcare team recommends it
Advanced CKD: Preparing for Stages 4-5
Your kidneys work at less than 30% capacity during stages 4-5 of chronic kidney disease. This phase needs careful planning to maintain quality of life and prepare you for the most important treatment decisions ahead.
Treatment options for severely reduced kidney function
Your healthcare team will likely discuss renal replacement therapy options when your eGFR drops below 30 ml/min. Some medications might need adjustment in stage 4 since they can accumulate in your bloodstream due to poor kidney function. Your doctor might prescribe treatments to manage complications like anemia, metabolic acidosis, mineral and bone disorders, and high potassium levels. ACE inhibitors, ARBs, SGLT2 inhibitors, or statins that helped in earlier stages are still vital to slow down disease progression.
Understanding dialysis and transplantation
Dialysis or transplantation becomes essential as your kidney function declines severely. Hemodialysis uses a machine to filter your blood through a surgically created vascular access. The process usually takes 4 hours and happens three times weekly. You can do peritoneal dialysis at home, which uses your abdominal lining as a filter.
Kidney transplants offer better outcomes than dialysis, with improved quality of life and survival. In India, success rates are high—about 99% one-year and 96% five-year survival for living donors, and 97% and 90% respectively for deceased donors. Overall success is around 95%. The evaluation process should begin when your eGFR falls below 20 ml/min/1.73m² to allow for testing and possible pre-emptive transplantation before dialysis initiation.
Epitome Hospitals: Best Kidney Care in Delhi
For comprehensive and advanced Kidney Treatment in Delhi NCR, Epitome Hospitals stands out as a leading institution. Epitome Hospitals offers a multidisciplinary approach to manage all stages of CKD. Our team comprises with the Best Nephrologists, providing personalized care and treatment plans tailored to individual patient needs.
Epitome Hospitals is also a renowned Kidney Transplant center in Delhi, with high success rates and a dedicated transplant team. Equipped with state-of-the-art facilities, Epitome Hospitals is committed to being the Best Kidney Disease centre, ensuring patients receive world-class care throughout their CKD journey.
Conclusion
Understanding the stages of chronic kidney disease is the first step towards proactive health management. Early detection and tailored strategies, from lifestyle adjustments to advanced therapies like dialysis and Kidney Transplant, are crucial. For those seeking the Kidney Disease centre, Epitome Hospitals, with its team of the Best Nephrologists, offers comprehensive Kidney Treatment.
Recognizing the stages and seeking timely care at a leading institution like Epitome Hospitals, the Chronic Kidney Disease Hospital, can significantly impact patient outcomes and quality of life.