Stage

Description†

GFR (mL per minute per 1.73 m2)

Action plan

-

At increased risk for chronic kidney disease

> 60 (with risk factors for chronic kidney disease)

Screening, reduction of risk factors for chronic kidney disease

1

Kidney damage with normal or elevated GFR

> 90

Diagnosis and treatment, treatment of comorbid conditions, interventions to slow disease progression, reduction of risk factors for cardiovascular disease

2

Kidney damage with mildly decreased GFR

60 to 89

Estimation of disease progression

3

Moderately decreased GFR

30 to 59

Evaluation and treatment of disease complications

4

Severely decreased GFR

15 to 29

Preparation for kidney replacement therapy (dialysis, transplantation)

5

Kidney failure

< 15 (or dialysis)

Kidney replacement therapy if uremia is present

Type

Definition

Examples

Susceptibility factors

Factors that increase susceptibility to kidney damage

Older age, family history of chronic kidney disease, reduction in kidney mass, low birth weight, U.S. racial or ethnic minority status, low income or educational level

Initiation factors

Factors that directly initiate kidney damage

Diabetes mellitus, high blood pressure, autoimmune diseases, systemic infections, urinary tract infections, urinary stones, obstruction of lower urinary tract, drug toxicity

Progression factors

Factors that cause worsening kidney damage and faster decline in kidney function after kidney damage has started

Higher level of proteinuria, higher blood pressure level, poor glycemic control in diabetes, smoking

End-stage factors

Factors that increase morbidity and mortality in kidney failure

Lower dialysis dose (Kt/V)*, temporary vascular access, anemia, low serum albumin level, late referral for dialysis