Patient Education by Southwest Virginia Nephrology Medicine, PC  


What are the States of Chronic Kidney Disease (CKD)?

Below show the five stages of CKD and estimated glomerular filtration rate (eGFR) for each stage:

  • Stage 1 normal or high eGFR (eGFR > 90 mL/min/1.73 m2)Kidney function is normal but tests show early evidence of kidney disease. Usually there are symptoms of kidney damage.
  • Stage 2 Mild CKD (EGFR = 60-89 mL/min1.73 m2) Same.
  • Stage 3A Moderate CKD (eGFR = 45-59 mL/min/1.73 m2) and Stage 3B Moderate CKD (eGFR = 30-44 mL/min/1.73 m2) –  Some call this stage the beginning of CKD by eeGFR and ignore stages 1-2, but I disagree. Stage 3 CKD should be referred to nephrologists with the aim to identify individuals at risk of progressive renal disease, and reduce associated risks, unless the creatinine is not elevated
  • Stage 4 Severe CKD (eGFR = 15-29 mL/min/1.73 m2) – The entire point CKD staging is to prevent referrals to nephrologists at this stage. When CKD4 has set in, it is a matter of time before they completely fail. Frequent clinic visits, multiple medication additions and changes including injections, frequent labs, and preparation for renal replacement therapy is the rule.
  • Stage 5 End Stage CKD (eGFR – Very severe, or end stage kidney failure that requires dialysis or kidney transplant, but neither are treatments delivered.
  • Stage 6 End Stage CKD (eGFR Dialysis.

Note also, abnormal urinary protein, called proteinuria carries a significant prognostic factor for progression to end stage renal failure and frequently the staging is two dimensional based on normal proteinuria, microscopic prioteinuria, and overt proteinuria, P1, P2, P3 respectively. This is one of the reasons I call CKD G1P3 a chronic kidney disease.

What is the Anatomic Stratification of CKD?

Like acute renal Failure, Chronic kidney disease (CKD) or failure is delineated into one or more of the following locations:

  • Pre-renal Causes – caused by a heart attack/disease, severe burn, liver problems, dehydration, allergic reaction, severe infection and blood pressure/anti-inflammatory medications.
  • Post-renal Causes – caused by cancers (prostate, cervical, colon and bladder) or other conditions that block the urinary passageways including an enlarged prostate, kidney stones, blood clots, and damage to the nerves that control your bladder block the urine passageways. Other conditions can interfere with urination and possibly lead to kidney failure.
  • Intra-renal Causes –  caused by heavy metals, drugs, antibiotics, chemotherapy drugs, vasculitis, lupus, nephritis, and systemic conditions like myeloma.

Need help to Determine in which State of CKD You in?

Southwest Virginia Nephrology Medicine in Franklin County are specialists in the states of Chronic Kidney Disease (CKD). If you need a Nephrologist, please call Southwest Virginia Nephrology Medicine in Roanoke, Virginia at (540) 904.5366 or complete the contact us form (click here). We provide specialized Nephrology services in Virginia and West Virginia, including Blacksburg, Bristol, Buena Vista, Christiansburg, Covington, Galax, Lexington, Martinsville, Norton, Radford, Roanoke, Salem, Wythevill and surrounding areas.