CKD Stages: The Progression of Chronic Kidney Disease Caring for your kidney disease at every stage.
Copyright 2005 Fresenius Medical
STAGES 1 and 2
DESCRIPTION
GFR (mL/min/1.73m)
CLINICAL SIGNS/SYMPTOMS
Stage 1: Kidney damage with normal or increased Glomerular Filtration Rate (GFR)
Stage 1: Greater than 90
Stage 1: High blood pressure, urinary tract infections, abnormal urinalysis (test of the urine)
Stage 2: Kidney damage with mild decline in Glomerular Filtration Rate (GFR)
Stage 2: From 60-89
Stage 2: High blood pressure, urinary tract infections, abnormal urinalysis (test of the urine)
National Kidney Foundation. K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification and Stratification. Am J Kidney Dis 39:S1-S000, 2002 (suppl 1)
Goals for Stage 1&2: Diagnosis and treatment of underlying disease (hypertension, diabetes, etc.) and/or infection, treatment of other medical conditions, slow down the progression of CKD, reduce risks of complications. What can I do to help myself? See your Primary Care Physician (PCP) on a regular basis to have your blood tested for health problems. Ask these questions: • What is my blood pressure? • Am I at risk for high blood pressure? • What can I do about it? • What is my A1C? (diabetics only) • What can I do about it? • What is my cholesterol? • Am I at risk for high cholesterol? • What can I do about it?
STAGES 1 & 2
Seek information about health problems and Chronic Kidney Disease, and attend a Fresenius TOPs session in your area. Make healthy lifestyle changes; quit smoking, exercise regularly, eat healthy (see a dietitian for specific recommendations), reduce stress, get enough sleep. Get medical attention for health problems like headaches, fatigue, increased thirst, frequent urination or burning during urination, unexplained weight gain or loss. “Know your flow”- ask your doctor for your GFR and monitor it regularly according to his/her recommendation.
STAGE 3
GFR (mL/min/1.73m)
DESCRIPTION
Moderate decrease in Glomerular Filtration Rate (GFR)
From 30 to 59
CLINICAL SIGNS/SYMPTOMS
Low blood count, malnutrition, bone pain, abnormal nerve sensations such as tingling and numbness, reduced mental functioning and sense of well-being
National Kidney Foundation. K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification and Stratification. Am J Kidney Dis 39:S1-S000, 2002 (suppl 1)
Goals for Stage 3: Evaluate your condition with your doctors and treat complications. Slow down the progression of the disease by treating the underlying condition (hypertension, diabetes, etc.) and modifying therapy for those conditions as required. What can I do to help myself? See your doctor and discuss changes in your lab values and symptoms you may be experiencing. Ask your doctor the following questions: • Do I have high blood pressure? • What can I do about it? • Is my blood sugar high? • What can I do to lower it? • What is my A1C? (diabetics only) • Am I at risk for anemia? • What can I do about it?
Get a referral to a Fresenius TOPS Session; begin with a visit to a nephrologist (a physician who specializes in kidney disease). Work with your Fresenius UltraCare team (PCP, Nephrologist, Nurse Practitioner, Registered Dietitian and Social Worker) to correct anemia, malnutrition and bone disease. Get further information regarding kidney disease and learn how you can slow its progression. Control blood pressure, blood sugar and high cholesterol.
• What is my albumin? Take all medications as prescribed. • Is my diet giving me what I need? • Is there something I should add to my diet? • Am I at risk for malnutrition? • What can I do about it? • What is my cholesterol? • How can I lower it?
Continue with healthy lifestyle changes. Get support from your Fresenius Social Worker. Your Social Worker will assist you in finding support groups, financial assistance, employment counseling and answer insurance questions. “Know your flow” - ask your doctor for and continue to monitor your GFR.
STAGE 3
STAGE 4
GFR (mL/min/1.73m)
DESCRIPTION
Severe decline in Glomerular Filtration Rate (GFR)
From 15 to 29
CLINICAL SIGNS/SYMPTOMS
Severe complications such as anemia, high blood pressure and bone disease
National Kidney Foundation. K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification and Stratification. Am J Kidney Dis 39:S1-S000, 2002 (suppl 1)
Goals for Stage 4: Control blood pressure, blood sugar and cholesterol. Prepare for kidney replacement therapy, learn about different ways to treat kidney failure, have access created for dialysis. What can I do to help myself? Speak with your Fresenius TOPs educator regularly (PCP, Nephrologist, Nurse Practitioner, Registered Dietitian and Social Worker). Get education regarding renal replacement therapies and talk about your options with your Fresenius TOPs educator to decide the best choice for you. Read the Fresenius Medical Care Patient Handbook for ESRD Patients and ask questions. Educate yourself and your family as thoroughly as possible. Request placement of your access. For hemodialysis either a fistula or a graft are considered the best options. For peritoneal dialysis a PD catheter is placed in your lower abdominal area. Visit a local dialysis center and ask for a tour, this is a great opportunity to ask questions.
STAGE 4
STAGE 5
GFR (mL/min/1.73m)
DESCRIPTION
Kidney Failure
Less than 15
CLINICAL SIGNS/SYMPTOMS
Uremia (build up of waste products in your blood), anemia, malnutrition, hyperparathyroidism, high blood pressure, swelling in hands/legs/eyes/sacrum, shortness of breath
National Kidney Foundation. K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification and Stratification. Am J Kidney Dis 39:S1-S000, 2002 (suppl 1)
Goals for Stage 5: Dialysis or kidney transplant. Treat other medical diseases and complications.
What can I do to help myself? Follow the prescribed renal replacement therapy as planned. Get involved with a Fresenius Medical Care dialysis center or transplant program. Be an active participant in your renal care. Keep taking medications and/or attending dialysis sessions as prescribed by your doctor. This is extremely important to your health and well-being. Seek needed support (social, financial, etc.) by asking your Fresenius Medical Care Social Worker for assistance and/or resources. See your doctor for changes in your health; cold or flu symptoms, new or unusual symptoms/problems, and changes to, or worsening of, existing symptoms/problems. Get education about lifestyle changes to expect as a transplant or dialysis patient and ask questions.
STAGE 5
Your TOPs Educator:____________________________________________ Phone Number: _______________________________________________ Email Address:________________________________________________
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Fresenius Medical Care North America 920 Winter Street Waltham, MA 02451-1457 For more information about the Treatment Options Program Call Toll Free: 1-877-TOPS-LIFE (1-877-867-7543) www.UltraCare-Dialysis.com Copyright © 2008, 2010 Fresenius Medical Care North America. All rights reserved.
The following are trademarks or service marks of Fresenius Medical Care Holdings, Inc. or its affiliated companies – Fresenius Medical Care® and UltraCare®. All other marks are owned by their respective companies. TOP024 (4/2010)
