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
