CKD Staging based on GFR
Stage 1 is defined as a GFR >90 mL/min/1.73 m2, while the fifth stage, kidney failure, is defined as a GFR <15 mL/min/1.73 m2. Anemia is associated with not only stage 5 disease, where it is universal, but also with earlier stages.
Below shows the five stages of CKD and GFR for each stage:
– 90 – 60 – 45 – 30 – 15 –
| CKD stage | GFR level | Description |
|---|---|---|
| Stage 1 | ≥ 90 | Kidney damage with normal or elevated GFR |
| Stage 2 | 60 – 89 | Kidney damage with mildly decreased GFR |
| Stage 3A | 45-59 | Moderately decreased GFR |
| Stage 3B | 30-44 | Moderately decreased GFR |
| Stage 4 | 15 – 29 | Severely decreased GFR |
| Stage 5 | < 15 or dialysis | Kidney failure |
* Stage 3 is 30-59 but is divided into 3A and 3B. GFR level is measured in units of mL/min/1.73 m2
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Stage 1 with normal or high GFR (GFR > 90 mL/min)
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Stage 2 Mild CKD (GFR = 60-89 mL/min)
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Stage 3A Moderate CKD (GFR = 45-59 mL/min)
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Stage 3B Moderate CKD (GFR = 30-44 mL/min)
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Stage 4 Severe CKD (GFR = 15-29 mL/min)
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Stage 5 End Stage CKD (GFR <15 mL/min)
Once you know the GFR you can determine a stage of kidney disease.
Albuminuria categories in CKD
| Category | ACR (mg/g) | Description |
| A1 | <30 | Normal to mildly increased |
| A2 | 30-300 | Moderately increased* |
| A3 | >300 | Severely increased** |
Albumin-to-Creatinine Ratio = ACR
*Relative to young adult level.
**Including nephrotic syndrome (albumin excretion ACR >2220 mg/g)
References