Understanding the Stages of Chronic Kidney Disease

Too often, people “crash” into dialysis—landing in the hospital with no idea their kidneys were failing. That’s because chronic kidney disease (CKD) often has no visible symptoms in its early stages. Many people don’t know they have it until they’ve reached end-stage kidney disease, when their only treatment options are dialysis or a transplant.

But CKD doesn’t happen overnight. There are actually five different stages of kidney disease. And if caught early enough, it can often be managed with lifestyle changes like diet, exercise, and blood pressure control.

In honor of this past July being Chronic Disease Month, we’re breaking down what those stages mean and why it matters for people across Oregon, Washington, and beyond.

What Are the Stages of CKD?

CKD is classified into five stages based on how well the kidneys are working. This is typically measured by a blood test called estimated glomerular filtration rate (eGFR), which tells us how efficiently the kidneys are filtering waste from the blood. Here's what each stage means:

Stage 1 (eGFR 90 or higher):

Kidney function is still normal, but there may be signs of damage—like protein in the urine. Most people don’t have symptoms at this stage, and many don’t even know they have CKD.

Stage 2 (eGFR 60–89):

A mild decrease in kidney function, with similar signs of damage. Like Stage 1, symptoms are usually not noticeable, but it’s an important time to monitor and protect kidney health.

Stage 3a (eGFR 45–59) and 3b (eGFR 30–44):

At this point, kidney function is moderately reduced. Some people may begin to experience symptoms like fatigue, swelling, or changes in urination. Complications such as high blood pressure or anemia may also start to develop.

Stage 4 (eGFR 15–29):

A severe drop in kidney function. Symptoms become more noticeable, and treatment planning often begins. This is when discussions about dialysis or transplant preparation may start.

Stage 5 (eGFR less than 15):

This is kidney failure, or end-stage kidney disease. At this point, dialysis or a transplant is needed to survive.

Early stages of CKD often go unnoticed, but that’s when intervention is most effective. That’s why regular checkups and testing are so important – especially since nearly 1 in 2 adults in the United States is living with chronic disease, and CKD is a major part of that picture.

This past July, in recognition of Chronic Disease Month, we honored those living with CKD and raised awareness so fewer people have to “crash” into dialysis. We’re proud to partner with organizations like the Chronic Disease Coalition, who are leading the charge to protect and uplift the voices of the chronic disease community every day.

This past Chronic Disease Month, we challenge you to take charge of your kidney health. Whether that means scheduling lab work, talking with your doctor, or connecting with others, every step forward is a victory worth celebrating.