Facts About Stages Of Kidney Failure

Chronic kidney disease (CKD) is a form of kidney impairment that lasts for more than a few months. Chronic kidney disease does not automatically mean kidney failure. There are 5 stages of kidney failure starting from mild damage to severe loss of function. Not all CKD progress to severe kidney failure.

Stages Of Kidney Failure:

The stages of kidney failure are determined by measuring eGFR i.e., the glomerular filtration rate. It is a measure of how well the kidneys are filtering the blood.

Stage - 1: In stage 1, almost 90% of kidney functions is maintained with a very mild excretion of protein in urine. It is not considered as kidney disease unless confirmed by scan reports.

Stage - 2: In stage 2, the kidney functions for about 60-89% which indicates mild loss of kidney function.

Stage - 3: The third stage of kidney failure is divided into stage 3a and 3b. The kidney function declines to about 30% and the rate of disease progression will be very high from this stage.

Stage - 4: The fourth stage is when severe loss of kidney function starts. Only 15-29% of the kidney functions remain.

Stage - 5: In the final stage, the kidney function drops below 15%. This is also referred to as the end-stage kidney disease.

When a doctor suspects that your kidney has stopped functioning normally, the primary approach of forming a diagnosis would be to determine whether the problem is acute or chronic and the stage of damage. Early detection and treatment improve the chances of preventing the progression of stages of kidney failure and, in some cases, improve kidney function. Read further to know random facts about the stages of kidney failure and whether it is possible to reverse kidney damage.

1. The stages of kidney failure vary depending on whether the damage is acute or chronic:

Acute kidney injury stages progress from risk, injury and result in failure, whereas chronic kidney disease progresses through five stages. Risk factors such as lack of blood flow, diabetes insipidus, electrolyte imbalance, etc., cause acute kidney injury. This is known as the onset phase. After this phase, the symptoms of injury show up in the form of fluctuations in the urine output. This denotes the oliguric phase and diuretic phase, where the urine output reduces to less than 400ml per day and rises to 3-4 litres per day, respectively.

In chronic kidney disease, the stages are determined based on how well your kidneys work to filter the waste products from your blood. This can be measured using the eGFR test (Glomerular Filtration Rate test) and urine test. Stages 4 and 5 chronic kidney diseases require renal replacement therapies such as dialysis and transplantation.

2. Not everyone with kidney disease experiences symptoms:

In the early phases, there will be little to no symptoms. Some warning signs include dehydration and sensitivity to medications. Generally early stages of kidney disease won't show symptoms but some may feel pretty sick at much earlier stages. Once you are diagnosed with kidney problems, it is advisable to monitor your blood pressure regularly and pay attention to your urinary habits. Ensure that you check with your nephrologist regularly to know your health status. 

3. Some warning signs will always be there:

While not everyone with kidney disease experiences the same symptoms, the warning signs are always detectable through a blood test, blood pressure values and changes in urine. As the stages of kidney failure progress, the levels of urea and creatinine increase in the blood, which shows up in blood tests. In these stages, one might notice the changes in the frequency of passing urine, blood pressure, bone problems and anaemia. In the later or end stages of kidney disease, the blood pressure almost always remains high.

4. Progression of the stages of kidney failure:

Recurring symptoms of acute kidney injury like tiredness, oedema (swelling in hands and feet), dark coloured urine, urinary tract infections and low urine output can influence the risk of long-term kidney damage. A person hospitalized for acute kidney injury should regularly attend follow up consultations with their healthcare providers to prevent the risk of disease progression. 

Any medicine or food that is not suitable for your kidneys can be a triggering cause of progression to advanced stages of kidney failure. Pre-existing health issues like diabetes, high blood pressure, high cholesterol, obesity determine the rate at which the disease is likely to progress.

5. It is possible to prevent the progression of stages of kidney disease:

While there is no miracle ‘cure’ for kidney disease, it is possible to prevent it from progressing to the next steps. This can be achieved through adequate lifestyle modifications and controlling blood pressure. Maintaining healthy blood pressure reduces the burden on your kidneys, allowing them to heal from the damage. 

In acute kidney injury, frequent check-ups with the healthcare provider can help identify the root cause of kidney injury and the factors that trigger the risk of further injury. The primary step to stop the progression of acute kidney injury and reverse kidney damage is the elimination of toxic substances (medicines or food) that are known to trigger further injury.

Early treatment can delay the progression to the next stages of kidney failure. Your food habits and lifestyle matter. Pay attention to your lifestyle and habits to make necessary changes. Seek professional help if you smoke or consume alcohol frequently.

6. Possibility to reverse kidney damage:

It is likely to reverse kidney damage if the condition is acute. Identifying the source of toxicity on the kidneys and eliminating them will reverse kidney damage in acute kidney disease. It takes approximately 2-3 weeks to witness improvement in kidney function. But it takes more than 12 months to reverse kidney damage due to acute kidney injury. Some patients do not improve and progress to the end stages of kidney failure. While this is a known fact, a study published by Weis et al. concluded that it is possible to improve glomerular filtration rate and kidney functions in chronic kidney disease irrespective of the stage of kidney disease.

What Can You Do?

Be prompt on your medical check-up. If your physician confirms that you have kidney disease, know your eGFR levels and the stage of your kidney problem. The stages of kidney failure and their progression varies from individual to individual. Discuss the possible management strategies with your healthcare provider and seek help when necessary.