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4 Categories of Kidney Disease: What Nephrologists Want to Know

If you have just learned that you have chronic kidney disease (CKD), you are probably more than a little frustrated. But once you have been diagnosed, your doctor will explain an important aspect of your condition: the "stage" of your disease.


"It is very important to know this, so that you can take appropriate steps to control your CKD, or at least reduce its progression," said Richard Glassock, MD, a professor from David Geffen School of Medicine at UCLA and former President. both the American Society of Nephrology and the National Kidney Foundation (NKF).



What are the stages of chronic kidney disease?


There are five main stages of kidney disease ranging from very small (stage 1) to renal failure (stage 5). Based on how well your kidneys work to filter out waste products and fluids in your blood, Drs. Glassock tells health officials.


Your doctor can determine your stage by measuring your glomerular filter (GFR), also known as the eGFR, or standard glomerular filter level. According to NLM, this test checks how well your kidneys are working by measuring how much blood flows through your glomeruli — the small kidney filters that remove impurities and fluids from your bloodstream — every minute. It then calculates how much creatinine, waste, is found in your blood. That level, along with other factors, including your age, race, and gender, determines your GFR.


Stage 1


GFR levels: 90 or higher


If you have Stage 1 kidney disease, it means your kidneys are functioning well but you have symptoms of minor kidney damage, says the American Kidney Fund (AKF). At this stage, you probably have no symptoms, other than protein in your urine when you check your urine at your doctor's office. Other warning signs could be high blood pressure or swelling in your legs, Robert Greenwell, MD, nephrology chief at Mercy Medical Center in Baltimore, tells Health.


What to do: deal with subtle health conditions. "High blood pressure and type 2 diabetes are two of the most common causes of chronic kidney disease stage 1," so it is very important to take control measures, "he said. Greenwell. It is important to lose weight, get regular exercise. , eat a healthy diet, and quit smoking if you do.


Stage 2


GFR levels: between 60 and 89


The good news is that your kidneys are still healthy and functioning well; The bad news is that they are showing obvious signs of physical harm, and some people still do not have symptoms, says Dr. Glassock. But you may notice that you are rushing to the toilet more than usual, and if you check the urine, it will show high levels of albumin, which is the main protein in your blood.

"Healthy kidneys secrete excess fluid and waste from your bloodstream, but allow protein to get back into your bloodstream," explains Dr. Glassock. He says: “When they are damaged, they allow albumin to get out of their filters, so they end up in your urine. As proteins help regulate the amount of fluid in your body, you may notice a buildup of fluid, especially in your calves, ankles, and feet.


What to do: at this point, the treatment is very similar to the stage says Dr. Glassock. If you have high blood pressure, you may already be using high blood pressure medications such as angiotensin-converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers (ARBs). But if you do not, your doctor may recommend that you use them now. "These drugs also help protect your kidneys from further damage," explains Dr. Glassock.


Stage 3



GFR levels: between 30 and 59


When you get to this stage, your kidneys show real damage. As a result, they are not working as well as they should, says Dr. Glassock. Stage 3 is divided into two categories: Stage 3a means you have a GFR between 45 and 59, and Stage 3b is a GFR between 30 and 44. As well as possible symptoms during phase 1 and phase 2, Drs. Glassock says you also have an increased risk of these serious health conditions:


* Osteoporosis. Since your kidneys are unable to filter out waste products as they normally do, the essential minerals that make up bones such as calcium and phosphorus are excreted. This puts you at greater risk for arthritis.


* Anemia. One in seven people with CKD continues to develop the disease, and it usually appears late, says Drs. Glassock. Here's why: When you have kidney disease, your kidneys cannot produce enough of the hormone known as EPO, which helps your body build more red blood cells, he explains. As a result, the number of red blood cells decreases. You are especially at risk if you are over 60 and / or have type 2 diabetes.


What you need to do: all the steps you have taken during phase 1 and phase 2 — control your diabetes and blood pressure, do not smoke, eat a healthy diet, and be active for many days a week — are still important, emphasizes Drs. Glassock. . If you have not already done so, you may want to do so now.


It is very important to avoid foods high in sodium, potassium, and phosphorus, as all of these can make the existing CKD worse, says a Cleveland clinic. You will also need to limit protein, as that can put a lot of strain on your kidneys, notes NKF. You may also need to reduce the amount of fluid, as damaged kidneys have a problem with it, which means it can accumulate in your body, says NLM.


Section 4


GFR levels: between 15 and 29


If you have stage 4 CKD, your kidneys are severely damaged. This is the last stage before kidney failure. As well as the symptoms that appear in stage 3, you may have jaundice, which includes yellowing of your eyes, says NKF. Other health conditions such as osteoporosis and anemia can be very serious, NKF.


What to do: your doctor should have regular blood tests to check the levels of calcium, phosphorus, vitamin D, says NFK. Another hormone they can test is your parathyroid hormone (PTH). PTH draws calcium from your bones to try to “correct” the fact that you do not have enough in your blood. As a result, this could lead to arthritis, the AKF said.


You should also talk to them about scanning for bone density to diagnose osteoporosis. If you have other conditions that could be more serious kidney disease, such as high blood pressure or type 2 diabetes, it is important to control yourself now.


You will also need to do dialysis, which is a mechanical procedure to remove waste from your body when your kidneys can no longer function. There are two main types of dialysis:


* Hemodialysis. Your blood is mechanically transported to remove waste products and fluids, which are then returned to your body. It is done at the clinic and takes a lot of time: three to four hours, at least three times a week, says the NKF.


* Peritoneal dialysis. Dialysis solution is injected directly into your stomach to absorb waste, which is excreted through a catheter. You can do this type of dialysis yourself, at home. Many people choose to do it while sleeping so that they can continue working and do other things during the day, says the NKF. But it’s not squeamish: you need to relax running the machine and inserting and removing the machines from your stomach.