Understanding the Stages of Chronic Kidney Disease
How CKD is staged by eGFR, what each stage means clinically, and how treatment goals change as the disease progresses.
Last updated: 2026-09-24
Chronic kidney disease is staged using the estimated glomerular filtration rate (eGFR), a number derived from blood creatinine together with age and sex. The stage communicates how much filtering capacity remains and guides how intensively the condition should be monitored and treated.
The five stages
| Stage | eGFR (mL/min/1.73m²) | Clinical meaning |
|---|---|---|
| G1 | 90 or above | Normal filtration with other evidence of kidney damage |
| G2 | 60–89 | Mildly reduced filtration with evidence of damage |
| G3a | 45–59 | Mild to moderate reduction |
| G3b | 30–44 | Moderate to severe reduction |
| G4 | 15–29 | Severely reduced filtration |
| G5 | Below 15 | Kidney failure |
Why protein in the urine matters too
Two people can share an eGFR and have very different outlooks. The amount of protein (albumin) in the urine is an independent marker of risk, which is why modern staging pairs the eGFR grade with an albuminuria category. A report that gives only an eGFR is missing half the picture.
How goals change by stage
In early stages the aim is slowing progression and protecting the heart and blood vessels. In later stages the focus shifts to managing anaemia, mineral and bone disorders, and preparing for renal replacement therapy — dialysis or transplantation.
Frequently asked questions
What does stage 3 kidney disease mean?
Stage 3 means moderate reduction in filtration (eGFR 30–59). Treatment concentrates on slowing progression and managing complications such as anaemia and blood-pressure problems.
When is dialysis usually started?
Dialysis is typically considered when eGFR falls below about 15, or earlier when symptoms such as fluid overload, difficult-to-control potassium, or severe acidosis appear.