The kidneys perform several essential functions, including filtering waste products from the blood, regulating fluid and electrolyte balance, helping control blood pressure and supporting red blood cell and bone health.

When kidney damage or reduced kidney function persists, it may be classified as chronic kidney disease (CKD).

People often search for the “stages of kidney failure in humans” when they receive an abnormal creatinine or eGFR report. However, CKD develops across a spectrum, and not every person diagnosed with CKD has kidney failure.

The modern classification divides kidney function into G1 through G5 categories based on eGFR. Albuminuria and the underlying cause of kidney disease are also important when estimating risk.

At Prabhakar Bhurke Clinic, Dr. Sandip Prabhakar Bhurke, super specialist nephrologist and transplant physician, provides individualized evaluation and treatment for patients with kidney disease ranging from early CKD to advanced kidney failure.

The 5 Main Stages of Chronic Kidney Disease

CKD stage	eGFR (mL/min/1.73 m²)	General meaning
Stage 1 / G1	≥90	Normal or high filtration with evidence of kidney damage
Stage 2 / G2	60–89	Mildly decreased filtration with evidence of kidney damage
Stage 3a / G3a	45–59	Mild to moderately decreased kidney function
Stage 3b / G3b	30–44	Moderately to severely decreased kidney function
Stage 4 / G4	15–29	Severely decreased kidney function
Stage 5 / G5	<15	Kidney failure range

G1 and G2 do not automatically mean CKD based on eGFR alone. Evidence of kidney damage must also be present and persist for at least three months.

Stage 3 is divided into 3a and 3b because the degree of kidney-function reduction differs substantially between these ranges.

Stage 1 Kidney Disease: Early Kidney Damage

At Stage 1, the eGFR is 90 or higher, but there is evidence of kidney damage.

Possible markers include:

• Albumin in urine

• Persistent blood in urine caused by kidney disease

• Structural abnormalities

• Certain inherited kidney conditions

• Other evidence of kidney damage

Many people at this stage have no obvious symptoms.

The main goal is to identify the cause and prevent further kidney injury.

Management may include:

• Blood-pressure control

• Diabetes management

• Treatment of the underlying kidney condition

• Monitoring urine albumin

• Avoiding unnecessary kidney-harming medicines

• Healthy lifestyle measures

• Regular kidney-function monitoring

Early detection can provide an opportunity to address risk factors before substantial loss of filtration occurs.

Stage 2 Kidney Disease: Mild Reduction in Kidney Function

Stage 2 generally corresponds to an eGFR of 60–89, together with evidence of kidney damage.

Like Stage 1, Stage 2 CKD may produce few or no symptoms.

A person may discover the condition through:

• Routine blood tests

• Urine testing

• Blood-pressure evaluation

• Diabetes-related screening

• Investigation of another medical problem

Treatment depends on the cause.

For example, patients with diabetes may require careful glucose and kidney-risk management, while those with significant albuminuria may need specific kidney-protective treatment when appropriate.

A mildly reduced eGFR should not be interpreted in isolation. Trends over time and urine albumin provide additional information about kidney health.

Stage 3 Kidney Disease: Moderate Kidney Function Loss

Stage 3 is divided into:

Stage 3a

eGFR: 45–59 mL/min/1.73 m²

Stage 3b

eGFR: 30–44 mL/min/1.73 m²

At this point, kidney function is more clearly reduced.

Some patients remain relatively well, while others may develop complications or symptoms depending on the cause and severity of disease.

Possible findings can include:

• Fatigue

• Changes in urination

• Swelling

• High blood pressure

• Anemia

• Electrolyte abnormalities

• Protein in urine

However, symptoms vary and cannot reliably determine the CKD stage.

Why Stage 3 Needs Regular Monitoring

Doctors may monitor:

• eGFR

• Serum creatinine

• Urine albumin

• Blood pressure

• Potassium

• Bicarbonate

• Hemoglobin

• Calcium and phosphorus when appropriate

Medication doses may also need review as kidney function changes.

Stage 4 Kidney Disease: Severe Reduction in Kidney Function

Stage 4 CKD corresponds to an eGFR of 15–29 mL/min/1.73 m².

This is considered severely decreased kidney function.

Some people may experience:

• Swelling

• Fatigue

• Nausea

• Reduced appetite

• Itching

• Changes in urine output

• Muscle cramps

• Sleep problems

• Breathlessness

• Anemia

• Mineral and bone abnormalities

Not every patient develops these symptoms.

Why Stage 4 Requires Advanced Planning

Stage 4 is an important point for discussing future kidney-care options.

Depending on the rate of kidney-function decline and overall health, the nephrologist may discuss:

• Strategies to slow progression

• Management of CKD complications

• Medication adjustments

• Dietary planning

• Dialysis education

• Vascular access planning when appropriate

• Peritoneal dialysis

• Kidney transplantation

• Conservative kidney management

Planning for possible kidney replacement therapy does not mean dialysis must begin immediately.

Stage 5 Kidney Disease: Kidney Failure Range

Stage 5 corresponds to an eGFR below 15 mL/min/1.73 m² and is commonly referred to as the kidney failure range.

At this stage, the kidneys have very severely reduced filtration capacity.

Possible complications include:

• Fluid retention

• High potassium

• Metabolic acidosis

• Anemia

• Bone and mineral abnormalities

• Loss of appetite

• Nausea

• Itching

• Severe fatigue

• Difficulty concentrating

• Breathlessness

• Uremic symptoms

However, eGFR alone does not determine when dialysis should start.

The nephrologist considers symptoms, laboratory abnormalities, fluid status, nutritional condition and other complications.

Does Stage 5 Always Mean Dialysis?

No.

An eGFR below 15 places a person in the kidney failure range, but dialysis is not automatically started solely because of a particular eGFR value.

Some patients may be managed without immediate dialysis while they remain clinically stable.

Dialysis may become necessary when kidney failure produces complications that cannot be adequately controlled with medical treatment.

Potential indications include:

• Severe fluid overload

• Persistent dangerous potassium elevation

• Significant metabolic acidosis

• Uremic complications

• Severe symptoms attributable to kidney failure

• Certain toxin exposures

The decision is individualized by the treating nephrology team.

Is There a Stage 6 of Kidney Failure?

No standard CKD classification includes a Stage 6.

The commonly used CKD categories range from G1 to G5.

The term “Stage 6 kidney failure” may sometimes appear informally online, but it is not part of the standard adult CKD staging system.

A person with Stage 5 CKD may receive dialysis, undergo transplant evaluation or receive conservative kidney management depending on their clinical situation and treatment preferences.

How Do Doctors Determine the Stage of Kidney Disease?

CKD staging should not be based on creatinine alone.

eGFR

eGFR estimates how effectively the kidneys filter blood.

It is calculated using laboratory measurements and demographic information. Because it is an estimate, doctors interpret it in the context of the patient's overall condition.

Urine Albumin

A urine albumin-to-creatinine ratio, or UACR, helps identify albumin leakage from the kidneys.

Albuminuria is an important part of kidney-risk assessment and can influence prognosis even when eGFR is relatively preserved.

Kidney Disease Duration

A reduced eGFR or evidence of kidney damage generally needs to persist for more than three months to establish chronic kidney disease rather than a temporary kidney problem.

Underlying Cause

Doctors also try to determine why kidney damage has occurred.

Possible causes include:

• Diabetes

• High blood pressure

• Glomerular diseases

• Polycystic kidney disease

• Recurrent obstruction

• Kidney stones

• Autoimmune diseases

• Inherited kidney disorders

• Medication-related kidney injury

• Other chronic kidney conditions

Can Kidney Disease Move From One Stage to Another?

Yes.

Some people experience gradual decline in kidney function, while others remain stable for years.

Kidney function can also temporarily worsen because of an acute illness, dehydration, infection, urinary obstruction or medication-related injury.

Therefore, one abnormal creatinine or eGFR result should not automatically be interpreted as permanent progression to a new CKD stage.

Doctors often compare multiple measurements over time because eGFR trends can provide more useful information than one isolated value.

What Increases the Risk of Kidney Disease Progression?

Several factors can increase the risk of worsening kidney function.

These include:

• Poorly controlled diabetes

• High blood pressure

• Increasing albuminuria

• Recurrent acute kidney injury

• Smoking

• Cardiovascular disease

• Persistent urinary obstruction

• Certain untreated kidney diseases

• Inappropriate medication use

Higher albuminuria and declining eGFR are important indicators of increased progression risk.

Symptoms Across the Different Kidney Disease Stages

Symptoms do not always correspond neatly to CKD stage.

Early Stages

Stages 1 and 2 often have few or no noticeable symptoms.

Middle Stages

Stage 3 may be associated with fatigue, swelling, changes in urine or complications such as anemia, although some people remain relatively asymptomatic.

Advanced Stages

Stages 4 and 5 are more likely to involve complications such as:

• Fluid retention

• Itching

• Nausea

• Appetite changes

• Electrolyte abnormalities

• Anemia

• Bone and mineral problems

• Breathlessness

• Uremic symptoms

Because symptoms are unreliable for staging, blood and urine testing remain important.

Can Kidney Failure Be Prevented From Getting Worse?

Progression cannot always be stopped, but appropriate treatment may reduce modifiable risks.

Depending on the diagnosis, kidney care may include:

• Maintaining appropriate blood-pressure control

• Managing diabetes

• Treating significant albuminuria

• Using kidney-protective medicines when indicated

• Avoiding unnecessary NSAIDs and other kidney-harming substances

• Managing cholesterol and cardiovascular risk

• Treating urinary obstruction

• Addressing recurrent kidney stones

• Following an individualized diet

• Monitoring kidney function regularly

KDIGO's current CKD guideline emphasizes risk assessment, management of complications and individualized treatment across CKD stages.

When Should a Person See a Nephrologist?

A kidney specialist may be appropriate when there is:

• Persistent reduction in eGFR

• Significant protein or albumin in urine

• Rapidly changing kidney function

• Persistent blood in urine

• Difficult-to-control hypertension

• Recurrent kidney stones or obstruction

• Electrolyte abnormalities

• Stage 3b, Stage 4 or Stage 5 CKD

• Suspected glomerular or inherited kidney disease

• Kidney failure requiring dialysis or transplant assessment

Early specialist involvement can help identify the cause, estimate progression risk and develop an appropriate treatment plan.

Kidney Failure Treatment Options

Treatment depends on the CKD stage, underlying cause and complications.

Medical Kidney Care

Earlier-stage disease may be managed with medicines, blood-pressure and diabetes control, dietary measures and monitoring.

Dialysis

When kidney failure causes complications that cannot otherwise be controlled, kidney replacement therapy may be required.

Options include:

• Hemodialysis

• Peritoneal dialysis

Kidney Transplantation

For selected patients with kidney failure, a kidney transplant may provide functioning kidney tissue and eliminate the need for dialysis if successful.

Eligibility requires comprehensive medical evaluation.

Conservative Kidney Management

Some patients may choose comprehensive non-dialysis management depending on age, health status, frailty, symptoms and personal goals.

This decision should be made through shared discussion with the medical team.

Kidney Care at Prabhakar Bhurke Clinic

At Prabhakar Bhurke Clinic, Dr. Sandip Prabhakar Bhurke, super specialist nephrologist and transplant physician, provides individualized evaluation and management for different stages of chronic kidney disease.

Depending on the patient's condition, care may include:

• CKD stage assessment

• Creatinine and eGFR monitoring

• Urine albumin evaluation

• Identification of the underlying kidney disease

• Blood-pressure management

• Diabetes-related kidney care

• Medication review

• Electrolyte and acid-base management

• CKD complication management

• Dialysis planning and evaluation

• Kidney transplant-related assessment

• Long-term kidney-function monitoring

Treatment is based on the patient's kidney function, disease cause, progression risk and overall health.

Frequently Asked Questions

How many stages of kidney failure are there?

CKD is commonly divided into five main GFR categories, G1 through G5. Stage 3 is further divided into 3a and 3b. G5 represents the kidney failure range.

Which stage is considered kidney failure?

Stage 5, or G5, corresponds to an eGFR below 15 mL/min/1.73 m² and is the kidney failure range. However, dialysis does not automatically begin based on eGFR alone.

Is Stage 3 kidney disease kidney failure?

No. Stage 3 represents moderate reduction in kidney function and is not the same as kidney failure.

Is Stage 4 kidney disease serious?

Stage 4 represents severely decreased kidney function. It requires close nephrology follow-up and planning for possible advanced kidney-care needs.

Does Stage 5 kidney disease always require dialysis?

Not necessarily. Dialysis decisions depend on symptoms, complications, laboratory abnormalities, fluid status and overall clinical condition.

Is there a Stage 6 kidney disease?

There is no standard Stage 6 in the commonly used CKD classification. G5 is the kidney failure category.

Can kidney disease stages improve?

An apparent improvement can occur when a temporary factor such as dehydration, infection, obstruction or acute kidney injury is treated. Established chronic kidney damage may not be completely reversible.

Can someone live for years with kidney disease?

Yes. The course varies greatly. Some people remain stable for many years, while others progress more rapidly. The cause, eGFR trend, albuminuria, age, diabetes, blood pressure and cardiovascular health all influence prognosis.

Conclusion

Understanding the stages of kidney failure in humans helps explain how kidney function is classified and why treatment needs change as CKD progresses.

The five major GFR categories range from G1 through G5, with Stage 3 divided into 3a and 3b. Stage 5 represents the kidney failure range, but the need for dialysis is determined by the patient's overall clinical condition rather than an eGFR number alone.

Early detection, regular monitoring of eGFR and urine albumin, treatment of the underlying cause and control of modifiable risk factors can help protect kidney function.

If kidney function is declining or you have been diagnosed with CKD, a nephrologist can help determine the current stage, assess progression risk and plan appropriate treatment.

For specialist kidney care and individualized CKD management, 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 professional medical diagnosis, treatment or individualized medical advice. CKD staging is based primarily on eGFR together with evidence of kidney damage and chronicity, while prognosis also depends on albuminuria, the underlying cause and other health factors. A single creatinine or eGFR result does not necessarily establish a CKD stage. Stage 5 is the kidney failure range, but dialysis is not automatically required solely because eGFR is below a particular number. Do not start, stop or change medicines, fluid intake, diet or dialysis treatment based solely on this article. Consult Dr. Sandip Prabhakar Bhurke or another qualified nephrologist for personalized evaluation and treatment.