Stages of Kidney Disease

hello welcome to chronic kidney disease
program at University of California San Diego my name is Danita Trzebinksa
and I’m a nephrologist in our clinic in this module we are going to talk about
the different stages of chronic kidney disease chronic kidney disease is quite
common it affects 11% of u.s. population which
translates to about 30 million people another 30 million people are at risk
for developing CKD at some point in their lives ideally we would like to
prevent individuals from developing CKD in the first place
but unfortunately that is not always possible early detection is the second
best option in order to take appropriate actions to slow down the decline of
kidney function let’s talk about estimating kidney function it’s usually
not as precise or easy as checking your weight or even measuring electrolyte
levels in your blood doctors nurses pharmacists use special
equations to estimate kidney function based on the level of creatinine in the
blood what is creatinine well creatinine is a waste product generated by muscle
metabolism and removed or excreted if you will from the body by kidneys the
higher the creatinine level in the blood the less efficient kidneys are at
removing it from the body so the worse the level of kidney function is the term
for the level of kidney function is glomerular filtration rate or GFR GFR
is the rate at which kidneys filter toxins from the blood this number also
correlates with overall kidney function we stage kidney disease or assign
severity based on the GFR it is extremely important that you know your
GFR in simple terms you can think of GFR as a percentage of normal kidney
function for example GFR 40 means that your overall kidney function yes for
both kidneys is about 40 percent of normal please remember it is just an
estimate and not a true measure of your kidney function also you need to realize
that GFR fluctuates from day to day just like your blood pressure does or
stock market does so we look at the trend and not necessarily every
individual value will now go over stages of chronic kidney disease there are five
of them with one being the least severe and five being the most severe in stage
one chronic kidney disease GFR is relatively preserved greater than ninety
so it’s considered normal or close to normal yet there are some other markers
of kidney disease for example there’s protein in the urine and we’ll talk more
about this a little bit later so that’s stage one chronic kidney disease in
stage two CKD GFR is mildly reduced to between 60 and 89 and there are some
other markers of kidney injury most of the time it’s protein again you will see
that protein is important now stage 3 this is the middle route kidney disease
and also the most common category GFR in CKD three is moderately reduced is
between 30 and 59 so not normal but not so bad at this stage you may begin to
see complications of chronic kidney disease now let’s move to stage four in
stage four CKD GFR is between 15 and 29 this is considered a pretty
advanced stage so we start talking about what the kidney’s future might halt
we might discuss potential plans for either dialysis or transplantation or
above whatever is most appropriate for you in stage 5 GFR is less than 15 being
in stage 5 does not automatically mean that you need to start dialysis some
patients can remain stage 5 for quite a few years without requiring dialysis in
general we do not start patients on dialysis even one day sooner then it is
necessary and most of the time patients tell me when it is necessary they feel
it they can tell it is important to realize that dialysis is just a tip of
the iceberg chronic kidney disease is a prevalent
yet silent disease most patients do not know that they have it since CKD is not
associated with clear symptoms till the disease is quite advanced therefore it
is important to screen patients at increased risk for developing chronic
kidney disease let’s do two questions to test your understanding of this module
the first question is what is GFR that’s an easy one and the answer is GFR is a
glomerular filtration rate which is the rate at which the kidneys filter toxins
from the blood and it is an estimation of overall kidney function what is the
most common stage of chronic kidney disease remember there are five stages
of chronic kidney disease and the question is which one is most common the
correct answer is stage 3 is the most common
age of chronic kidney disease congratulations at this point you have
completed the module on the stages of chronic kidney disease please check our
website for additional educational modules on kidney health

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