Glomerular filtration rate
Glomerular filtration rate (GFR) is considered by medical professionals to be the best measure of kidney function. Knowing someone's GFR lets them figure out their stage of kidney disease. Doctors will use this information to plan their patient's treatment.
Stage 1 and Stage 2 Kidney Disease
In Stage 1 and Stage 2 CKD, there are often few symptoms. Early CKD is usually diagnosed when there is:
- High blood pressure
- Higher than normal levels of creatinine or urea in the blood
- Blood or protein in the urine
- Evidence of kidney damage in an MRI, CT scan, ultrasound, or contrast X-ray
- A family history of polycystic kidney disease
Stage 3 Kidney Disease
In Stage 3 CKD, anemia (a shortage of red blood cells) and/or early bone disease may appear and is usually treated to help the patient feel their best and reduce problems down the road.
Stage 4 Kidney Disease
When CKD has progressed to Stage 4, it's time to begin preparing for dialysis and/or a kidney transplant. If GFR falls below 30 most people need to see a kidney disease specialist (called a nephrologist). The kidney doctor will talk about treatments for kidney failure like dialysis or kidney transplant. A GFR below 15 indicates that one of these treatments is necessary. (Find a kidney disease specialist)
In chronic kidney disease, the kidneys don't usually fail all at once. Instead, kidney disease often progresses slowly, over a period of years. This is good news because, if CKD is caught early, medications and lifestyle changes may help slow its progress and keep a person feeling their best for as long as possible. With early diagnosis, it may be possible to slow, stop, or even reverse CKD, depending on the cause and the circumstances of the patient.
Stage 5 Kidney Disease
A person with Stage 5 CKD has end stage renal disease (ESRD) with a GFR of 15 ml/min or less. At this advanced stage of kidney disease the kidneys have lost nearly all their ability to do their job effectively, and eventually dialysis or a kidney transplant is needed to live.
People diagnosed with Stage 5 CKD will need to see a nephrologist immediately. This is a doctor who is trained in kidney disease, kidney dialysis and transplant. The doctor will help decide which treatment is best for the patient — hemodialysis, peritoneal dialysis (PD) or kidney transplant — and will recommend an access for dialysis. A nephrologist will develop an overall care plan and manage the patient's healthcare team.
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