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Chronic Kidney Disease - Stages. Know the Symptoms

Chronic Kidney Disease (CKD) is a condition involving a slow, gradual loss of proper kidney function. To better diagnose the disease and monitor its progress, individual chronic kidney disease stages...

Chronic Kidney Disease (CKD) is a condition involving a slow, gradual loss of proper kidney function. To better diagnose the disease and monitor its progress, individual chronic kidney disease stages serve as an effective method of analyzing each patient on a case-by-case basis. While early stages may not produce noticeable or uncomfortable symptoms, as the disease progresses, so will the severity of mounting problems. Read on for an in-depth dive into the individual stages of CKD and their symptoms.

What Is Chronic Kidney Disease?

Patients suffering from chronic kidney disease (CKD) experience a gradual loss of kidney function. Initially, the condition may not cause immediate concern or raise alarms, as in the earliest stages, it shares many of its symptoms with other, less threatening conditions, such as an ordinary urinary tract infection.

That is, however, when most issues begin to mount drastically. Misguidedly ignoring or brushing off initial warning signs could lead to CKD progressing to more dangerous stages, where medical intervention becomes mandatory.

Who Is at Risk of CKD?

Most healthy adults do not need to worry about chronic kidney disease symptoms. Due to its nature as a severe complication of other kidney-related issues, in the vast majority of cases, CKD only develops in individuals suffering from pre-existing conditions.

However, several factors can increase the risk of developing chronic kidney disease:

    1. Diabetes: Kumar et al. reported a bidirectional link between CKD and diabetes. Elevated blood sugar levels eventually lead to an increased strain on the nephrons and their cells in the kidneys, heavily contributing to the development of chronic kidney disease.
    2. Hypertension: Chronic hypertension is a risk factor for developing CKD because elevated blood pressure causes blood vessels to narrow over time. Eventually, this can lead to a vasculopathy in the kidneys, contributing to CKD.
  • Ethnicity: People of African American, Hispanic, Asian, or Native American descent are, on average, at a higher risk of developing CKD. 
    1. Family history of CKD: Since both diabetes and hypertension occur more frequently in patients with a family history of these conditions, many cases of CKD are effectively considered congenital.
    2. Heart disease: Various kinds of heart disease are caused by diabetes and high blood pressure, creating a profound link between a patient’s cardiovascular health and their risk of contracting CKD. Moreover, the overlap between the two conditions means that one also exacerbates the effects of the other.
    3. Being overweight: Obesity, a sedentary lifestyle, and unhealthy dietary habits contribute to poor kidney health by increasing the chances of diabetes, heart disease, and hypertension, in turn increasing the risk of CKD.

    What Are the Stages of Chronic Kidney Disease?

    As mentioned above, chronic kidney disease stages vary in severity of symptoms and effectively reflect the damage incurred by the patient’s kidneys at the time of diagnosis. 

    So, what are the stages of chronic kidney disease, and what should you know about them and their symptoms? Below, we characterize each stage and highlight what to look out for if you’re a person at risk of CKD.

    Chronic Kidney Disease – Stage 1

    At this stage, kidney function is considered to be only mildly impaired. Many people experience no symptoms or are not bothered by them simply because they don’t immediately signal a cause for concern. In other cases, symptoms reminiscent of urinary tract infections may be present, as well as mild proteinuria or swollen hands and feet.

    What complicates matters further is that definite CKD markers, such as the estimated glomerular filtration rate (eGFR) or urine albumin-creatinine ratio (uACR), need to be measured for months in order to obtain an accurate CKD diagnosis.

    Therefore, prompt detection remains key to obtaining a timely diagnosis and preventing damage as early as possible. Fortunately, this is now possible thanks to at-home kidney tests, which can measure eGFR and allow for a timely medical intervention and treatment.

    Chronic Kidney Disease – Stage 2

    Much like in the previous stage, stage 2 of chronic kidney disease patients likewise won’t show many symptoms, if at all. However, potential signs of kidney damage may start emerging. Protein presence in urine also becomes more noticeable, including to the naked eye, as proteinuria often manifests through foamy urine.

    Chronic Kidney Disease – Stage 3

    Stage 3 chronic kidney disease signifies moderate kidney damage. At this time, symptoms start to become noticeable and raise concern in patients. eGFR readings will drop to anywhere between 30 and 59, with lower scores indicating a decreased ability of the kidneys to filter waste out.

    Other symptoms include:

    • Dark-colored urine
    • Frequent urination
    • Feelings of weakness and fatigue
    • Higher blood pressure
    • Insomnia
    • Itchy skin
    • Unexplained weight loss
    • Lack of appetite 

    Chronic Kidney Disease – Stage 4

    Lastly, what is chronic kidney disease stage 4? This stage represents a significant decline in kidney function. Individuals diagnosed with this condition require regular health check-ups and need to be closely monitored for complications, such as high blood pressure.

    In addition to all the other symptoms highlighted above, stage 4 symptoms include:

    • Difficulty concentrating
    • Bodily aches and pains
    • Numbness in extremities
    • Shortness of breath
    • Odorous breath with a distinct ammonia or fish-like scent

    The Takeaway

    Chronic kidney disease affects millions, especially those diagnosed with or at risk of diabetes and high blood pressure. CKD often works in tandem with these other conditions, either causing them or being caused by them. Therefore, the most effective weapon against chronic kidney disease and its complications lies in maintaining a healthy lifestyle, retaining optimal body weight, and regularly visiting a doctor whenever early signs of diabetes or hypertension arise.

    You may also read: What Indicates Renal Tubular Acidosis? Urine pH & More


    1. Kumar M, Dev S, Khalid MU, Siddenthi SM, Noman M, John C, Akubuiro C, Haider A, Rani R, Kashif M, Varrassi G, Khatri M, Kumar S, Mohamad T. The Bidirectional Link Between Diabetes and Kidney Disease: Mechanisms and Management. Cureus. 2023 Sep 20;15(9):e45615. doi: 10.7759/cureus.45615. PMID: 37868469; PMCID: PMC10588295.


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