Understanding kidney disease.
A guide to chronic kidney disease (CKD), stages, monitoring, and protecting your heart and kidneys together.
Last reviewed: January 2025. Pending clinical review by Dr. Loccoh or Dr. Marinacci.
What is chronic kidney disease (CKD)?
CKD means your kidneys are damaged and can’t filter blood as well as they should. Most damage builds up slowly, often without symptoms, which is why screening matters.
The two key tests
eGFR, how well your kidneys filter
Estimated glomerular filtration rate. Higher numbers are better. eGFR is calculated from a blood creatinine test.
uACR, protein in your urine
Urine albumin-to-creatinine ratio. Lower numbers are better. Protein in the urine is often the earliest sign of kidney damage.
The five stages of CKD
- Stage 1: eGFR ≥90 with signs of kidney damage (e.g., protein in urine)
- Stage 2: eGFR 60–89 with signs of damage, mild loss of function
- Stage 3a: eGFR 45–59, mild to moderate loss
- Stage 3b: eGFR 30–44, moderate to severe loss
- Stage 4: eGFR 15–29, severe loss; prepare for dialysis/transplant planning
- Stage 5: eGFR <15, kidney failure; dialysis or transplant needed
The heart-kidney connection
CKD and heart disease share root causes, high blood pressure and diabetes. Damage in one system accelerates damage in the other. Protecting your heart protects your kidneys, and vice versa.
How to slow CKD progression
- Keep blood pressure at goal (often <130/80)
- Control blood sugar if you have diabetes
- Take medications that protect the kidneys (ACE/ARB, SGLT2) as prescribed
- Avoid NSAIDs (ibuprofen, naproxen) when possible
- Limit sodium; follow your provider’s diet plan
- Don’t smoke
- Move every day; aim for 150 min/week of moderate activity
Free support at HGF
Our screenings flag early kidney risk before you feel symptoms. Free to the participant.