Your kidneys play a vital role in your overall health. They filter waste and excess fluid from your blood to be excreted as urine. They also help regulate blood pressure, produce hormones and keep electrolytes balanced. When kidney function declines, waste builds up in the blood, causing a condition known as chronic kidney disease (CKD). According to the Centers for Disease Control and Prevention (CDC), CKD affects about 37 million U.S. adults. Knowing the stages of the disease and testing your kidney health early can help you prevent extensive damage before it occurs.
What is CKD?
Chronic kidney disease is a condition in which your kidneys are damaged and can't adequately filter blood. This damage tends to worsen slowly over many years. The most common causes of CKD are high blood pressure and diabetes, which impair the tiny blood vessels in the kidneys that filter waste. Having CKD increases your risk of developing heart disease and kidney failure if left untreated.
There are five stages of chronic kidney disease. Each stage is based on a measure called the estimated glomerular filtration rate (eGFR), which tells you how efficiently your kidneys filter blood, as well as other signs of kidney damage, such as albumin in the urine. When determining CKD stage, these tests usually need to be repeated to confirm long-term damage (lasting 3 months or more).
- Stage 1 CKD (eGFR 90+ mL/min and markers of kidney damage): Your kidneys are functioning well, but there are signs of kidney damage present, such as albumin in the urine
- Stage 2 CKD (eGFR 60-89 mL/min and markers of kidney damage): Kidney function is normal to slightly reduced, but there are signs of kidney damage present, such as albumin in the urine. There are often no symptoms in these early stages, so getting tested is important
- Stage 3a CKD (eGFR 45-59 mL/min): Mild to moderate loss of kidney function is present. Treatment will likely focus on slowing disease progression and reducing cardiovascular risk
- Stage 3b CKD (eGFR 30-44 mL/min): This stage is marked by moderate to severe loss of kidney function. Symptoms like fatigue, poor appetite and high blood pressure may begin to appear at this stage
- Stage 4 CKD (eGFR 15-29 mL/min): At this stage, there is severe loss of kidney function and typically more pronounced symptoms. Treatment will additionally focus on treating complications of CKD and preparing for kidney failure treatments
- Stage 5 CKD (eGFR <15 mL/min): Once kidney damage has progressed this far, kidney failure typically occurs and dialysis or transplant is needed. Fatigue, nausea, itching and trouble concentrating are common symptoms
Am I at risk for chronic kidney disease?
Common risk factors for CKD include:
- Diabetes
- High blood pressure
- Heart disease
- Family history of CKD
- Obesity
Symptoms of chronic kidney disease
In the early stages of CKD, there are often no symptoms. As kidney function declines, symptoms may include:
- Fatigue and weakness
- Poor appetite
- Nausea and vomiting
- Increased urination, especially at night
- Swelling in ankles and feet
- Muscle cramps
- High blood pressure
Testing for chronic kidney disease
Since CKD may be silent at first, getting tested is critical for early detection. Some tests that screen for kidney disease include:
- Urine albumin to creatinine ratio (ACR): ACR tests screen for kidney damage by calculating the ratio of albumin (a protein normally found in the blood but not in the urine) to creatinine (a waste product removed by the kidneys that comes from the digestion of protein and normal breakdown of muscle tissue) in your urine. If the ratio shows more albumin than there should be, it may indicate kidney damage
- Estimated glomerular filtration rate (eGFR): An eGFR test can gauge overall kidney function by revealing how well your kidneys are filtering certain waste products from your blood, such as creatinine or cystatin C (a protein produced by all cells in the body)
- Metabolic panel: With a metabolic panel, you can measure levels of key electrolytes and kidney markers in blood like creatinine. Labcorp OnDemand’s Comprehensive Metabolic Panel (CMP) test measures eGFR and creatinine in addition to several other components in the blood that are essential for metabolic health and may signal kidney problems
Treatment for chronic kidney disease
Since there is no cure for CKD, treatment focuses on slowing the progression of the disease and managing complications. Condition management for chronic kidney disease may include:
- Controlling blood pressure and blood sugar (if you are a diabetic)
- Changing your diet to be kidney-friendly (i.e., eating foods that help to lower cholesterol and limiting sodium, potassium and phosphorus)
- Treating other heart disease risk factors (e.g., high cholesterol medication, weight loss, quitting smoking)
- Taking medications to lower protein levels in urine or manage anemia (low blood count)
- Dialysis or transplant, if kidneys fail completely
The sooner chronic kidney disease is identified, the better. Take control of your kidney health by understanding the stages of CKD and getting timely testing. From Labcorp OnDemand’s Kidney Health and ACR Tests to our Comprehensive Metabolic Panel, there are several ways to start screening. Discuss any concerning test results with your healthcare provider right away to create a treatment plan. With knowledge and vigilance, it’s possible to live well with CKD.
