Because there are many stages of chronic kidney disease, there are many symptoms which correspond to the different stages. Chronic kidney disease is divided into five different stages based the rate at which the glomerulus filter the blood per minute. This is referred to as the glomerular filteration rate (GFR), and reflects how well a persons kidneys are filtering his or her blood. Doctors can determine the GFR by studying the creatinine levels present in a blood test! A persons GFR is normal if it is greater than 90 m per minute. GFR is an accurate measure of how well a persons kidneys are functioning.

A person with stage one chronic kidney disease (this is considered to be normal) will have a GFR that is slightly lower than 90 ml/minute. A person with stage two chronic kidney disease (the disease has progressed to the mild form at this stage) will have a GFR that is between 60-89 ml/minute. A person with stage three chronic kidney disease (the disease has progressed to the moderate form at this stage) will have a GFR between 30-59 ml/minute.


A person with stage 4 chronic kidney disease (the disease has in a severe form at this stage) will have a GFR between 15-29 ml/minute, and a person with stage five chronic kidney disease (the person is at end stage renal failure at this stage) will have a GFR that is less than 15 ml/minute.

People in the first stage of chronic kidney disease do not show any symptoms. Their serum and creatinine levels come back normal in routine blood tests. The only way stage one chronic kidney disease is detectable is through routine lab measurements, or through incidental diagnosis when other diseases are evaluated. Symptoms of stage one chronic kidney disease include: loss of protein in urine, structural damage that shows up on x-ray, ultrasound, or MRI images, or a family history of polycystic kidney disease.


People in the second stage of chronic kidney disease have mild kidney damage, but show no symptoms. Possible symptoms of stage two chronic kidney disease include: nocturia, elevated blood pressure, abnormal urine, and normal or slightly elevated serum creatinine levels. Their kidney functions are at 60-89%.

People in the third stage of chronic kidney disease have moderate kidney damage. Their kidney functions are at 30-59%. These people either show no symptoms, or show mild symptoms which are accompanied by abnormal urine, and elevated serum creatinine levels.

People in the fourth stage of chronic kidney disease have severe kidney damage. Their kidney functions are at 15-29%. These people show many symptoms which can either be mild, vague, and nonspecific to very severe. The underlying cause of kidney failure, and the disease itself determine the symptoms exhibited.

What kind of self care should a person do? See Ch7

People who develop kidney disease greatly shorten their average lifespans because they often times experience progressive kidney function loss which can lead to severe kidney failure and ultimately need dialysis or a kidney transplant to live longer. However, having a kidney transplant is very complicated and costly – only 5-10 percent of people in developing nations can afford treatment for kidney failure, which includes dialysis and kidney transplant, therefore prevention is the only option available for the masses because no cure for kidney disease currently exists.

Since healthy people can acquire chronic kidney disease, they should also take extreme care to ensure that they never develop kidney disease. They can do this by exercising regularly. Regular exercise and daily physical activity helps the body to control its blood sugar levels, and keep blood pressure at a normal level. People who exercise regularly and are very active are also less likely to become diabetic.

Healthy people should also eat a balanced diet that includes a plentiful variety of fruits and vegetables. They need to eat less refined sugar and processed foods. People who eat less salt are less likely to develop kidney stones and/or high blood pressure, especially if they are over 40. These people should also ensure that their body mass index (BMI) is within the normal range because maintenance of a proper weight ensures that their likelihood of developing chronic kidney disease, diabetes, heart disease, and other health problems is substantially reduced.

Healthy people should not smoke or use any kind of tobacco products because this can lead to atherosclerosis which reduces blood flow to the kidneys, and hence their optimal functioning capacity. People should also only use over the counter pain meds only when necessary because medicines like ibuprofen can cause kidney damage and failure if they are taken regularly. People who experience chronic pain should instead consult a doctor to find alternate ways to manage their pain.


Drinking at least 3 liters of water a day helps dilute urine, flush out toxic waste from the body, and prevents kidney stones. Because kidney disease often times does not show any symptoms until it has progressed to the advanced stages, people should see the doctor for regular kidney checkups. People who do not have diagnosed kidney disease, but who have diabetes, high blood pressure, are obese, and have a family history of kidney disease must get annual kidney checkups because they are at greatest risk of developing kidney disease. The same applies for people older than 40. Doctors will measure kidney function by a urine test, a blood test that measures creatinine levels, and a blood pressure test.

Kidney patients must take extra precautionary measures because their kidneys are already failing. They should watch for early symptoms of kidney disease which include: swelling of the feet and face, loss of appetite, nausea, vomiting, pale skin color, frequent urination, and blood or protein in the urine. People experiencing these symptoms should contact their doctor and be tested for kidney disease.

People who are diabetic must watch for the above mentioned symptoms because a large percentage of these people will develop chronic kidney disease, and kidney failure. In fact, diabetic kidney disease accounts for 45% of new end stage kidney disease cases every year. People with diabetic kidney disease can check for end stage kidney disease by way of a urine test done every three months which measures the level of protein through a dipstick, and a blood pressure test which is also done every three months. They should get a yearly urine test to check their microalbuminiuria levels. They should also get a yearly blood test done to measure their creatinine levels.

People should keep an eye on high blood pressure, protein in the urine, swelling, frequent reduction in blood sugar levels, reduction in insulin requirements, and the appearance of diabetic retinopathy because these are all symptoms of diabetes caused kidney disease. They should always consult their doctor after noticing even one of these symptoms. Diabetic people should control their diabetes, maintain a constant blood pressure measurement that is less than 130/80 mm of hg, and reduce the amounts of protein and fats that they consume to ensure that they never develop kidney disease.

Because high blood pressure is the second most common factor attributing to kidney disease which can be prevented, people with high blood pressure should always seek regular and continuous treatment for their hypertension, because the signs of kidney disease attributed to hypertension often do not show up until the disease has progressed to the advanced stages. All hypertensive patients should take their blood pressure medicines regularly, they should also have their blood pressure checked regularly, and eat a diet low in salt (because salt raises blood pressure.) their blood pressure measurements should never be above 130/80 mm of HG. They should also get their urine and creatinine levels checked annually.

People can ensure that they never develop kidney disease by constantly controlling their blood pressure. They should always keep their blood pressure under 130/80 mm of HG. They can do this by measuring their blood pressure regularly at home and charting the measurements to look for patterns. This practice will help the because it will let their doctor know if their blood pressure medicines need to be changed.

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