Chronic kidney disease diagnosis

Your healthcare provider will likely begin to diagnose¹⁰ kidney disease by consulting your personal and family health histories. They will take into account whether you have hypertension or have been taking medications that affect kidney function.

Your provider will also ask about your signs and symptoms and perform a physical exam to check for signs of problems with your heart or blood vessels. They may also conduct a neurological exam.

Your provider will likely order tests to determine whether you have chronic kidney disease. Some tests that can be used to diagnose CKD include:

• Blood tests: You may have a blood sample drawn to be tested for indicators of poor kidney function, such as a high concentration of waste products like creatinine and urea.
• Urine tests: Urinalysis (lab analysis of a urine sample) may help reveal abnormalities indicative of chronic kidney disease. This test may also help identify the underlying cause of your CKD.
• Imaging tests: Imaging tests, such as ultrasound, may be used to produce images of your kidneys’ structure and size.
• Kidney biopsy: Your provider may recommend having a sample of your kidney tissue removed for testing (biopsy). Kidney biopsies are often performed with patients under local anesthesia.

In this procedure, a long, thin needle is inserted through the skin into the kidney to remove a sample. This sample is then sent to a lab for testing to help determine the cause of your kidney problems.

If you have an underlying condition that increases your risk for kidney disease, your provider will likely ask to perform routine urine and blood tests to monitor your blood pressure and kidney function.

Chronic kidney disease stages

The stage¹¹ to which your kidney disease has progressed is determined by identifying how much kidney damage has occurred. This can be done by measuring your glomerular filtration rate, which indicates how well your blood is filtered by your kidneys.

The five stages of chronic kidney disease are:

• Stage 1: Kidney damage with normal kidney function (estimated GFR ≥90 mL/min per 1.73 m2)
• Stage 2: Kidney damage with mild loss of kidney function (estimated GFR 60-89 mL/min per 1.73 m2)
• Stage 3: Mild-to-severe loss of kidney function (estimated GFR 30-59 mL/min per 1.73 m2)
• Stage 4: Severe loss of kidney function (estimated GFR 15-29 mL/min per 1.73 m2)
• Stage 5: Kidney failure requiring dialysis or transplant for survival, also known as end-stage renal disease (estimated GFR <15 mL/min per 1.73 m2)