Symptoms and diagnosis

Stage 2 of chronic kidney disease (CKD)

About chronic kidney disease (CKD)

With 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 you feeling your best for as long as possible.

Five stages of chronic kidney disease

To help improve the quality of care for people with kidney disease, the National Kidney Foundation (NKF) created a guideline to help doctors identify each level of kidney disease. The NKF divided kidney disease into five stages. When the doctor knows what stage of kidney disease a person has they can provide the best care, as each stage calls for different tests and treatments.

Glomerular Filtration Rate (GFR)

Glomerular filtration rate (GFR) is the best measure of kidney function. The GFR is the number used to figure out a person’s stage of kidney disease. A math formula using the person’s age, race, gender and their serum creatinine is used to calculate a GFR. A doctor will order a blood test to measure the serum creatinine level. Creatinine is a waste product that comes from muscle activity. When kidneys are working well they remove creatinine from the blood. As kidney function slows, blood levels of creatinine rise.

Below shows the five stages of CKD and GFR for each stage:

• Stage 1 with normal or high GFR (GFR > 90 ml/min)
• Stage 2 Mild CKD (GFR = 60-89 ml/min)
• Stage 3 Moderate CKD (GFR = 30-59 ml/min)
• Stage 4 Severe CKD (GFR = 15-29 ml/min)
• Stage 5 End Stage CKD (GFR <15 ml/min)

Dialysis or a kidney transplant needed in order to maintain health.

If you know a serum creatinine level, you can figure out a GFR using our GFR Calculator.

Stage 2 CKD

A person with Stage 2 CKD has kidney damage with a mild decrease in their GFR of 60-89 ml/min. There are usually no symptoms to indicate the kidneys are damaged. Because kidneys do a good job even when they’re not functioning at 100%, most people will not know they have Stage 2 CKD. If they do find out they’re in Stage 2, it’s usually because they were being tested for another condition such as diabetes or high blood pressure (the two leading causes of kidney disease).

Other ways a person may discover they are in Stage 2 CKD:

• 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

Regular testing for protein in the urine and serum creatinine can show whether the kidney damage is progressing. Living a healthy lifestyle can help slow progression of kidney disease. It is recommended that people in Stage 2 CKD:

• eat a healthy diet:
  • Include a variety of grains, especially whole grains, fresh fruits and vegetables
  • Choose a diet that is low in saturated fat and cholesterol and moderate in total fats
  • Limit intake of refined and processed foods high in sugar and sodium
  • Choose and prepare foods with less salt or high sodium ingredients
  • Aim for a healthy weight, consume adequate calories and include physical activity each day
  • Keep protein intake within the Daily Reference Intake (DRI) level recommended for healthy people
  • Consume the DRI for vitamins and minerals
  • Potassium and phosphorus are usually not restricted unless blood levels are above normal
• keep their blood pressure at a healthy level
  • 125/75 for those with diabetes
  • 130/85 for non-diabetes and non-proteinuria
  • 125/75 for non-diabetes with proteinuria
• keep their blood sugar or diabetes under control
• have regular checkups with their doctor and include a serum creatinine test to measure GFR
• take medicines as prescribed by their doctor
• exercise regularly
• stop smoking

There is no cure for chronic kidney disease, but it may be possible to stop its progress or at least slow down the damage. In many cases, the correct treatment and lifestyle changes can help keep a person and their kidneys healthier longer.

If you would like to see a doctor who specializes in the care of kidneys, called a nephrologist, you can use DaVita's Find a kidney doctor tool to locate a nephrologist in your area.