37 million adults in the United States are currently living with CKD; however, 90% do not know that they have the disease.
Chronic kidney disease (CKD) is a condition in which there is permanent damage to the kidneys that cannot be reversed. The damage to the kidneys can also get worse over time, leading to kidney failure. In CKD, the kidneys lose their ability to filter waste products and excess fluid (water) out of the blood.
If CKD is diagnosed early, treatment and management strategies can be implemented to keep the damage from worsening.
Key Points
- Chronic kidney disease is divided into five stages, which are based on estimated glomerular filtration rate (eGFR) results and how well the kidneys are functioning.
- Those with stage 1 CKD have a normal eGFR of 90 or higher with mild kidney damage for 3 months or more.
- Most people with stage 1 CKD do not present with any physical symptoms; however, there may be protein in the urine.
- The main goal of treatment in stage 1 CKD is to slow disease progression and ensure that the kidneys function well for as long as possible.
Stages of CKD
The stages of CKD are broken down into five stages. These stages are based on the estimated glomerular filtration rate (eGFR) test and show how well the kidneys are working to filter waste and excess fluid from the bloodstream. As the stages increase, the kidney damage worsens, and the more their function reduces.
During stages 1-3 (early stages) of CKD, the kidneys are still able to filter waste products out of the blood. In stages 4-5 (later stages), the kidneys have to work harder to filter the blood; they may be close to failing (stop working altogether).
Stage 1 CKD Overview
Stage 1 CKD means that the damage to the kidneys is mild. The kidneys are still able to work well; however, there may be signs and symptoms of kidney damage. In stage 1 CKD, the eGFR is in the normal range of 90 or greater. However, protein has been detected in the urine (proteinuria). The presence of protein in the urine means the person is in Stage 1 CKD.
Health Risks Associated with Stage 1 CKD
In stage 1 CKD, urine-albumin-creatine ratio (uACR) levels are used to determine the health risk. If, for 3 months or more, the uACR level is lower than 30, you are at the lowest risk for disease progression. As the uACR level increases, so does the risk of developing heart disease and worsening kidney disease.
If you have a uACR number of 30-300, then you are at an increased risk of your CKD worsening and are at a greater risk of developing heart disease. If your uACR number is higher than 300, you are at high risk for your CKD to worsen and to develop heart disease.
Signs and Symptoms of Stage 1 CKD
In stage 1 CKD, most people do not have any symptoms that impact their health. For this reason, many people do not know that they have CKD. Some signs and symptoms of CKD that can be noticed by doctors testing for health conditions or kidney damage or by people include:
- Swelling in the feet or hands
- Urinary tract infections (UTIs)
- Hypertension (high blood pressure)
- Proteinuria (protein in the urine)
- Hematuria (blood in the urine)
- Kidney damage that is present in an ultrasound, MRI, kidney biopsy, or CT scan
How is Stage 1 CKD Diagnosed?
A doctor or healthcare provider may test the health of the kidneys if there is a family history of kidney disease or health conditions that damage the kidneys, such as diabetes or high blood pressure. To determine if you have CKD, your doctor will administer the following tests:
- Spot urine tests for albumin-to-creatinine ratio (uACR) to detect albuminuria
- Urine tests
- Imaging tests to see visible kidney damage, such as an ultrasound, CT scan, or MRI scan
- Blood pressure checks
- eGFR blood tests
- Blood urea nitrogen (BUN) test
For stage 1 CKD to be diagnosed, there needs to be evidence of ongoing kidney damage.
How is Stage 1 CKD Treated?
In stage 1 CKD, the main focus is slowing down kidney damage and preserving kidney function for as long as possible. If you have diabetes, your doctor will work with you to control your blood sugar levels. You will need to keep your blood pressure in a healthy range to avoid speeding up disease progression and developing hypertension or hypotension. Your doctor will also determine if you need to start or stop any medicines to protect your kidneys.
If you do not already have a nephrologist, talk to your healthcare provider about finding one.
Stage 1 CKD Nutrition
In stage 1 CKD, you may not be required to implement any dietary restrictions. You will, however, need to start or continue eating a healthy diet, such as incorporating, more fruits, vegetables, lean meats, fish, and whole grains. You should limit the amount of processed foods, refined carbohydrates (sugars), and sweetened drinks.
If you have hypertension, it is important to reduce your daily sodium (salt) intake to less than 1 teaspoon (2300 mg) a day. Your healthcare provider will advise if this needs to be lower based on other health conditions.
Can you slow down the damage to the kidneys in Stage 1?
There are still a lot of things that you can do every day to help keep your kidneys working for as long as possible. Some lifestyle changes that you can implement include:
- Quit smoking or using tobacco products, as smoking can increase kidney disease progress and increase the risk of developing kidney failure.
- Maintain a healthy weight; your doctor will advise what this weight is for you.
- Eat a kidney-friendly diet, a dietician will help you plan healthy meals and snacks based on your results.
- Be active for at least 30 minutes most days of the week.
- Reduce or limit your alcohol intake.
- Get enough sleep.
- Find ways to reduce and manage stress.
Other ways to lower the risk of CKD disease progression include managing other health conditions such as diabetes, high blood pressure, and high cholesterol.
Panoramic Health
Panoramic Health is the leading integrated provider group delivering the future of kidney care. Our mission is to improve outcomes for patients by slowing disease progression and improving their quality of life. We do this through the distinctive capabilities of our comprehensive care model, which brings together an integrated provider group with operational support, clinical support, and data & analytics at scale.
Through partnerships with practices, providers, payers, and health systems, we work to advance the usage of clinically validated best practices and cutting-edge data analytics across a continuum of reimbursement models.
*No information presented here should be construed as medical advice. Every patient is unique, and patients should consult a qualified physician to determine what is best for them.
