Stage 1 kidney disease, also called G1 CKD, is an early category of chronic kidney disease in which the estimated glomerular filtration rate (eGFR) is 90 mL/min/1.73 m² or higher, but there is also evidence of kidney damage that has been present for at least three months.

This distinction is important.

An eGFR of 90 or above does not automatically mean that a person has CKD. According to the KDIGO 2024 CKD guideline, G1 represents normal or high GFR, and G1 qualifies as CKD only when there is another marker of persistent kidney damage.

Possible markers of kidney damage include:

• Persistent albuminuria

• Abnormal urine sediment

• Persistent blood in urine from a kidney-related cause

• Structural abnormalities on imaging

• Certain abnormalities related to kidney tubules

• Abnormal findings on kidney biopsy

• A history of kidney transplantation

At Prabhakar Bhurke Clinic, Dr. Sandip Prabhakar Bhurke, super specialist nephrologist and transplant physician, provides evaluation and long-term management for patients with early and advanced kidney conditions.

Why Can Kidney Disease Exist When eGFR Is Normal?

The kidneys can retain much of their filtering capacity during the early stages of kidney disease.

A person may therefore have an eGFR within the normal or high range while another part of the kidney is showing evidence of damage.

For example, persistent albumin in the urine can indicate injury to the kidney's filtering structures even when eGFR remains 90 or above.

This is why CKD assessment uses more than creatinine or eGFR alone. KDIGO classifies CKD according to cause, GFR category and albuminuria category.

Stage 1 Kidney Disease eGFR: What Does the Number Mean?

The G1 category corresponds to:

eGFR ≥90 mL/min/1.73 m²

However, eGFR should not be interpreted in isolation.

GFR category	eGFR range	General description
G1	≥90	Normal or high
G2	60–89	Mildly decreased
G3a	45–59	Mildly to moderately decreased
G3b	30–44	Moderately to severely decreased
G4	15–29	Severely decreased
G5	<15	Kidney failure

Importantly, G1 and G2 alone do not establish CKD when there is no evidence of kidney damage.

What Evidence of Kidney Damage Can Be Present in Stage 1?

A person with G1 CKD may have one or more markers of kidney damage.

Albumin in Urine

Albuminuria is one of the most important measurable markers of kidney damage.

A urine albumin-to-creatinine ratio (UACR) is commonly used to assess albumin leakage.

KDIGO categorizes albuminuria as:

• A1: less than 30 mg/g

• A2: 30–299 mg/g

• A3: 300 mg/g or higher

Persistent albuminuria can be important even when eGFR is preserved.

Blood in Urine

Persistent hematuria may sometimes be related to kidney disease.

However, blood in urine can have many causes, including urinary stones, infections and urological conditions. The source needs to be investigated rather than automatically attributed to CKD.

Abnormal Kidney Imaging

Ultrasound or other imaging may identify structural abnormalities that qualify as evidence of kidney disease.

Kidney Biopsy Findings

In selected patients, a biopsy may demonstrate a kidney disorder even when overall filtration remains relatively preserved.

Does Stage 1 Kidney Disease Cause Symptoms?

Often, stage 1 kidney disease causes no obvious symptoms.

This is one reason early kidney disease can go unnoticed.

A person may feel completely well while testing reveals persistent albuminuria, structural kidney abnormalities or another marker of kidney damage.

Symptoms such as swelling, significant changes in urine output, nausea or breathlessness are not required for CKD to be present.

NIDDK notes that testing may be the only way to identify kidney disease, particularly in people with risk factors.

What Are the Possible Causes of Stage 1 CKD?

The underlying cause matters because treatment should address the disease that is damaging the kidneys.

Common causes and associated conditions include:

Diabetes

Diabetes can gradually damage the kidney's filtering structures and cause albumin to appear in urine.

High Blood Pressure

Long-standing hypertension can contribute to kidney damage.

Glomerular Diseases

Conditions affecting the kidney's filtering units can cause proteinuria or hematuria while overall filtration remains preserved.

Inherited Kidney Disorders

Some inherited diseases can produce structural or functional kidney abnormalities before eGFR declines.

Polycystic Kidney Disease

People with inherited cystic kidney disorders may have structural kidney abnormalities despite preserved filtration during earlier disease.

Recurrent Stones or Obstruction

Repeated obstruction or complicated stone disease may contribute to kidney damage in some patients.

Autoimmune and Other Diseases

Certain autoimmune, inflammatory, infectious or medication-related conditions can affect kidney tissue.

Determining the cause is an important part of early kidney care.

Who Is More Likely to Develop Early Kidney Disease?

Kidney screening may be particularly relevant for people with:

• Diabetes

• High blood pressure

• Cardiovascular disease

• A family history of kidney disease

• Previous kidney injury

• Recurrent kidney stones

• Certain autoimmune diseases

• Known structural kidney abnormalities

• Certain inherited kidney disorders

NIDDK identifies diabetes, hypertension, heart disease and family history among important CKD risk factors.

How Is Stage 1 Kidney Disease Diagnosed?

Diagnosis generally requires more than a single abnormal test.

A nephrologist may review several types of information.

Serum Creatinine and eGFR

Blood creatinine is used to estimate kidney filtration.

An eGFR of 90 or above can fall into the G1 category, but evidence of kidney damage is needed to classify it as CKD.

Urine Albumin Testing

A UACR can detect albumin leakage that may not be apparent from symptoms.

Urinalysis

Urine testing may look for:

• Blood

• Protein

• Abnormal cells

• Other sediment abnormalities

Blood Pressure

Blood pressure should be assessed because hypertension can both contribute to kidney damage and occur as a consequence of kidney disease.

Kidney Imaging

Ultrasound, CT or other imaging may be appropriate when structural disease, stones, obstruction or congenital abnormalities are suspected.

Additional Testing

Depending on the suspected cause, a nephrologist may recommend:

• Blood glucose or HbA1c

• Electrolytes

• Autoimmune testing

• Specific infection testing

• Genetic evaluation

• Kidney biopsy in selected cases

Why Should a Single eGFR Not Be Used to Diagnose Stage 1 CKD?

Kidney function can vary temporarily because of illness, hydration status, medications and other factors.

More importantly, CKD is defined by persistence for at least three months.

KDIGO defines CKD as abnormalities of kidney structure or function that persist for a minimum of three months and have implications for health.

Therefore, a single eGFR result should not automatically be labelled as chronic kidney disease.

The doctor may compare previous tests and repeat appropriate investigations to establish chronicity.

Can Stage 1 Kidney Disease Get Worse?

It can, but progression is not inevitable.

Some people with early kidney abnormalities remain stable for many years, while others develop progressive kidney-function decline.

Risk depends on factors such as:

• Underlying kidney disease

• Albuminuria

• Diabetes

• Blood-pressure control

• Changes in eGFR over time

• Recurrent kidney injury

• Cardiovascular health

• Medication exposure

• Other medical conditions

NIDDK notes that progression risk varies and is influenced by factors including diabetes, increasing albuminuria, high blood pressure and decreasing eGFR.

What Is the Treatment for Stage 1 Kidney Disease?

There is no single medicine specifically labelled as a treatment for “stage 1 kidney disease.”

Treatment depends on why kidney damage is present.

For example:

• Diabetes-related kidney disease requires appropriate diabetes and kidney-risk management.

• Hypertension requires individualized blood-pressure treatment.

• Significant albuminuria may influence the choice of kidney-protective medicines.

• Glomerular diseases may require disease-specific treatment.

• Urinary obstruction may require restoration of urine flow.

• Kidney stones may require stone-specific management.

• Certain inherited or autoimmune disorders require specialized monitoring and treatment.

The aim is to address the underlying disease and reduce the risk of further kidney damage.

Can Stage 1 Kidney Disease Be Reversed?

The answer depends on what caused the kidney abnormality.

Some temporary abnormalities may resolve once the underlying problem is corrected.

However, established structural kidney damage or chronic scarring may not simply disappear.

Even when complete reversal is not possible, early management can focus on preventing additional injury and preserving kidney function.

Stage 1 Kidney Disease and Blood Pressure

Blood-pressure management is an important component of kidney protection.

High blood pressure can damage kidney blood vessels and filtering structures, while kidney disease can also contribute to hypertension.

The appropriate blood-pressure target depends on the individual patient.

Do not change blood-pressure medicines based only on an eGFR result. Treatment should be guided by the patient's complete medical history and kidney findings.

Stage 1 CKD and Diabetes

Diabetes is one of the major causes of CKD.

People with diabetes may develop albuminuria before substantial loss of filtration occurs.

For patients with diabetes and evidence of kidney disease, management may include:

• Individualized glucose control

• Blood-pressure management

• UACR monitoring

• eGFR monitoring

• Appropriate kidney-protective medicines

• Cardiovascular risk management

• Dietary and lifestyle measures

The treatment plan should be adjusted according to kidney function and the patient's overall health.

What Diet Is Appropriate for Stage 1 Kidney Disease?

There is no single stage 1 CKD diet suitable for everyone.

Dietary recommendations depend on the cause of kidney disease, blood pressure, diabetes, urine albumin, body weight, medications and laboratory results.

General kidney-supportive habits may include:

Limit Excess Sodium

Reducing excessive salt intake can help with blood-pressure management.

Avoid Extreme High-Protein Diets

People with early CKD should not automatically eliminate protein, but unnecessary excessive protein intake may not be appropriate.

Eat a Balanced Diet

A varied diet containing appropriate amounts of vegetables, fruits, whole grains and other nutritious foods may support overall cardiovascular health, with adjustments when specific kidney-related restrictions are required.

Maintain a Healthy Weight

Weight management can support blood pressure and metabolic health.

Major dietary restrictions should be discussed with a healthcare professional or renal dietitian.

Can Drinking More Water Treat Stage 1 Kidney Disease?

No.

Adequate hydration is important, but drinking excessive quantities of water does not repair chronic kidney damage.

Fluid requirements vary between individuals.

A person with stage 1 CKD does not automatically need a large increase in daily water intake, and people with other medical conditions may require different fluid recommendations.

What Lifestyle Changes Can Help Protect Kidney Function?

Early kidney disease is an opportunity to address modifiable risks.

Useful measures may include:

• Keep blood pressure within the individualized target.

• Manage diabetes appropriately.

• Avoid unnecessary NSAID use.

• Avoid smoking.

• Maintain a healthy weight.

• Stay physically active when medically appropriate.

• Follow prescribed medicines correctly.

• Avoid unverified kidney-detox products.

• Attend recommended kidney-function testing.

• Treat urinary problems and recurrent stones appropriately.

These measures support overall kidney and cardiovascular health but cannot guarantee that CKD will never progress.

How Often Should Stage 1 Kidney Disease Be Monitored?

There is no single monitoring schedule for every person with G1 CKD.

Monitoring frequency can depend on:

• Albuminuria category

• Underlying cause

• Diabetes

• Blood pressure

• eGFR trend

• Medication changes

• Other complications

People with higher-risk findings may require more frequent monitoring than someone with stable low-risk findings.

KDIGO's CKD framework combines GFR and albuminuria to help assess risk and guide monitoring.

Can Stage 1 Kidney Disease Lead to Kidney Failure?

It can in some patients, but stage 1 CKD does not mean that kidney failure is inevitable.

The long-term course depends on the cause and risk profile.

Persistent significant albuminuria, worsening eGFR, poorly controlled diabetes, uncontrolled hypertension and recurrent kidney injury can increase concern about progression.

Regular monitoring helps identify changes early.

When Should You See a Nephrologist?

A nephrologist may be appropriate when testing shows:

• Persistent albuminuria

• Unexplained blood in urine

• Structural kidney abnormalities

• Repeated abnormal kidney-function tests

• A suspected glomerular disease

• Difficult-to-control blood pressure

• Recurrent kidney stones with kidney-function concerns

• A family history of inherited kidney disease

• A progressive change in eGFR

Specialist evaluation can help determine whether the abnormal finding represents genuine CKD, identify its cause and establish an appropriate monitoring plan.

Early Kidney Care at Prabhakar Bhurke Clinic

At Prabhakar Bhurke Clinic, Dr. Sandip Prabhakar Bhurke, super specialist nephrologist and transplant physician, provides individualized assessment for patients with early kidney abnormalities and chronic kidney disease.

Depending on the clinical situation, evaluation may include:

• Review of creatinine and eGFR

• Urine albumin and protein assessment

• Blood-pressure evaluation

• Diabetes-related kidney assessment

• Kidney imaging review

• Evaluation of hematuria

• Assessment of kidney stones or obstruction

• Investigation of suspected glomerular disease

• Medication review

• Long-term CKD monitoring

The focus is on identifying the underlying cause and protecting kidney function over time.

Frequently Asked Questions

What is stage 1 kidney disease?

Stage 1 CKD corresponds to G1, where eGFR is 90 or higher, plus evidence of kidney damage that persists for at least three months. An eGFR of 90 or higher by itself does not mean a person has CKD.

Is stage 1 kidney disease serious?

It is an early category of CKD, but it should not be ignored. The significance depends on the underlying cause, albuminuria and other health factors.

Can stage 1 kidney disease have no symptoms?

Yes. Early kidney disease can be clinically silent, and testing may identify abnormalities before symptoms appear.

What is a normal eGFR in stage 1 kidney disease?

The G1 category is an eGFR of 90 mL/min/1.73 m² or higher. However, CKD requires evidence of kidney damage in addition to the G1 eGFR category.

Can stage 1 kidney disease be cured?

There is no universal cure because stage 1 CKD can have many different causes. Some reversible contributors may improve, while established chronic kidney damage may persist. Treatment focuses on the underlying condition and protection of kidney function.

What should I eat with stage 1 kidney disease?

There is no universal diet for everyone with stage 1 CKD. Sodium intake, protein intake and other dietary factors should be individualized according to kidney findings, diabetes, blood pressure and laboratory results.

Does stage 1 kidney disease require dialysis?

No. Stage 1 CKD is not a kidney-failure category and does not itself indicate a need for dialysis.

Can stage 1 kidney disease progress?

Some patients progress while others remain stable for long periods. Albuminuria, eGFR trends, the underlying cause, diabetes and blood-pressure control can influence risk.

Conclusion

Stage 1 kidney disease is an early form of CKD in which kidney filtration may still be normal or high, but there is evidence of kidney damage. An eGFR of 90 or higher alone is not enough to diagnose stage 1 CKD.

Because early kidney disease may produce few or no symptoms, urine albumin testing, kidney-function testing, blood-pressure assessment and appropriate imaging can be important for people at risk.

The most useful approach is to identify the underlying cause, manage conditions such as diabetes and hypertension, address albuminuria when present, avoid unnecessary kidney injury and maintain regular follow-up.

Stage 1 CKD does not automatically progress to kidney failure. Its long-term course varies according to the cause, albuminuria, eGFR trend and other individual risk factors.

For individualized assessment of early kidney disease and long-term kidney care, consult Dr. Sandip Prabhakar Bhurke at Prabhakar Bhurke Clinic.

Medical Disclaimer

This article is intended for general educational and informational purposes only and should not be considered a substitute for medical diagnosis, treatment or individualized medical advice. An eGFR of 90 or higher does not by itself establish stage 1 chronic kidney disease; evidence of kidney damage persisting for at least three months is also required. The cause, albuminuria, kidney-function trend, medications and overall health must be considered when evaluating early kidney disease. Do not start, stop or change prescription medicines, supplements, diet or fluid intake based solely on this article. Consult Dr. Sandip Prabhakar Bhurke or another qualified nephrologist for personalized evaluation and treatment.