Hi, thank you for your question. Chronic kidney disease can be categorised into 5 stages, based on the estimated glomerular filtration rate (eGFR), which measures how well the kidneys function. In stage 1, eGFR is 90 or above (normal) and there is slight kidney damage. You may have protein in your urine. In stage 2, level of kidney damage is similar to that of stage 1 except that eGFR is 60-89. In stage 3, eGFR is 30-59 and the kidneys are moderately damaged. Stage 3 can be further divided into stage 3a nd 3b. Stage 3a shows eGFR of 45-59, while stage 3b shows eGFR of 30-44.

Patients may experience symptoms like backache, swelling in hands and feet, and more/less urination. They may also have complications of kidney disease due to buildup of waste products and water in the body, for example, hypertension, bone disorders and anemia. In stage 4, eGFR is decreased to 15-29 and the kidneys are moderately or severely damaged.

Symptoms and complications become more common compared to stage 3. Stage 5 is also known as end stage renal disease (ESRD). eGFR falls below 15 and kidneys have little or no function left. Patients have severe symptoms like nausea, vomiting, back pain, muscle cramps, swelling, itching, less/more urination and trouble breathing. People in this stage will need dialysis or kidney transplant.

Early stages of kidney disease are managed by:

1. Keeping blood pressure, cholesterol and sugar levels under control.
2. Eating a healthy low-protein diet
3. Exercising regularly
4. Maintaining a healthy weight
5. Quit smoking
6. Medications – Diuretics to remove excess water, iron/erythropoietin supplements to produce more red blood cells, calcium and vitamin D supplements to protect the bones.

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