What Are the Stages of CKD? 🫘🗺️
This article is written by mr.hotsia, a long term traveler and storyteller who runs a YouTube travel channel followed by over a million followers. Over the years he has crossed borders and backroads throughout Thailand, Laos, Vietnam, Cambodia, Myanmar, India and many other Asian countries, sleeping in small guesthouses, village homes and roadside inns. Along the way he has listened to real life health stories from locals, watched how people actually live day to day, and collected simple lifestyle ideas that may help support better wellbeing in practical, realistic ways.
When people first hear “CKD stages,” they often picture a countdown. Stage 1… stage 2… stage 3… like the body is walking toward a cliff.
But in real life, CKD stages are better understood as a map, not a countdown. The stages help describe how much filtering capacity the kidneys have, and how much stress they may be under. Many people stay stable for years, especially when the main drivers are supported.
CKD staging is mainly based on two things:
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eGFR (estimated glomerular filtration rate)
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Urine albumin/protein (how much protein leaks into urine)
Doctors often use both together to estimate risk.
1) The eGFR stages (G1 to G5) 🧪
eGFR is a number calculated from a blood test (creatinine) plus factors like age and sex. It estimates how well kidneys filter.
Here are the common stages:
Stage 1 (G1): eGFR 90 or higher ✅
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Kidney filtering is normal or high
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But there is evidence of kidney damage (often protein in urine, blood in urine, structural changes, or genetic conditions)
Key idea: Stage 1 is not “no problem.” It often means “normal filter speed, but signs of stress or damage.”
Stage 2 (G2): eGFR 60 to 89 🟢
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Mildly reduced filtering
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Plus evidence of kidney damage
Key idea: Many people feel normal in Stage 1 and 2. Testing is what reveals it.
Stage 3 (G3): eGFR 30 to 59 🟡
This is split into:
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Stage 3a (G3a): eGFR 45 to 59
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Stage 3b (G3b): eGFR 30 to 44
Key idea: Stage 3 is “moderate” reduction. It is serious enough to monitor closely, but many people can remain stable for years.
Stage 4 (G4): eGFR 15 to 29 🟠
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Severe reduction in filtering
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Often needs closer follow up and planning
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Complications like anemia or mineral imbalance are more common
Key idea: Stage 4 often means preparation and careful management, not automatic emergency.
Stage 5 (G5): eGFR below 15 🔴
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Very low filtering capacity
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Sometimes called kidney failure
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Some people may need dialysis or transplant planning, depending on symptoms and overall health
Key idea: Stage 5 is not only about a number. Symptoms, lab patterns, and clinical context matter.
2) The urine albumin/protein categories (A1 to A3) 🫧
Urine protein helps show how stressed the kidney filters are.
Doctors often use albumin-to-creatinine ratio (ACR) categories:
A1: Normal to mildly increased
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ACR less than 30 mg/g
A2: Moderately increased
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ACR 30 to 300 mg/g
(Older term: “microalbuminuria”)
A3: Severely increased
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ACR above 300 mg/g
(Older term: “macroalbuminuria”)
Why this matters:
Higher protein leakage often signals higher risk of progression and higher cardiovascular risk, even if eGFR looks okay.
3) Why doctors use both together 🧭
Two people can have the same eGFR and very different risk.
Example:
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eGFR 55 with A1 (low protein) may be relatively stable for many people
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eGFR 55 with A3 (high protein) suggests higher kidney stress and higher risk
So CKD staging is not only “what stage am I?” but also “how much protein is leaking?”
4) What symptoms are common at each stage? 👀
Symptoms vary, and many people have none early.
Stage 1–2
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often no symptoms
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sometimes foamy urine (protein) or high blood pressure
Stage 3
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may still feel normal
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some may notice fatigue, mild swelling, or urination changes
Stage 4
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fatigue becomes more common
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swelling, appetite changes, itching, anemia, and mineral issues may appear
Stage 5
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symptoms are more likely (fluid overload, nausea, weakness, trouble concentrating)
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decision making about renal replacement options may be needed
Again: symptoms are not a reliable “stage meter.” Labs and trends are.
5) The practical goal at every stage 🛡️
Across all stages, many clinicians focus on the same big protective ideas:
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support healthy blood pressure
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support balanced blood sugar (if relevant)
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reduce urine protein when possible under clinician guidance
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avoid repeated dehydration, infection, and kidney injury
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review medications and supplements for kidney safety
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protect heart health
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monitor trends consistently
10 FAQs: What are the stages of CKD? ❓
1) What are the 5 stages of CKD?
Stages are mainly based on eGFR: Stage 1 (90+), Stage 2 (60–89), Stage 3 (30–59), Stage 4 (15–29), Stage 5 (below 15).
2) What is the difference between Stage 3a and 3b?
Stage 3a is eGFR 45–59. Stage 3b is eGFR 30–44. Stage 3b usually carries higher risk and often needs closer monitoring.
3) Why can someone have Stage 1 CKD with normal eGFR?
Because Stage 1 can mean kidney damage is present (like protein in urine) even if filtering capacity is still normal.
4) What does protein in urine mean for staging?
Protein is tracked separately (A1–A3). Higher protein leakage often signals higher kidney stress and higher risk.
5) Is eGFR always accurate?
eGFR is an estimate. It can be influenced by muscle mass, hydration, and other factors. Doctors look at trends and may use additional tests when needed.
6) Can CKD stage improve?
Sometimes eGFR and urine protein can improve if temporary factors are corrected or key drivers are supported. But long term scarring usually does not fully reverse.
7) Do symptoms always match CKD stage?
No. Many people have no symptoms in early and even moderate stages. Symptoms often appear later, but not always.
8) What stage is considered kidney failure?
Stage 5 is often called kidney failure, but the need for dialysis or transplant planning depends on symptoms and the overall clinical picture, not only the number.
9) What stage is most common?
Stage 3 is commonly diagnosed because it is where changes become clearer in routine testing.
10) What is the most important number besides eGFR?
Urine albumin/protein (ACR) is a major marker of kidney stress and risk.