End Stage Renal Disease Classifications

Five Stages in the progression to ESRD (nephropathy):

Stage I:

The flow of blood through the kidneys, and therefore through the glomeruli, increases -- this is called hyperfiltration - and the kidneys are larger than normal.

Stage II:

The rates of filtration remains elevated or at near-normal levels and the glomeruli begin to show damage. Small amounts of albumin leak into the urine.

Stage III:

The loss of albumin and other proteins in the urine exceeds 200 micrograms per minute. The glomeruli suffer increased damage. Some people develop high blood pressure in this stage. The kidneys progressively lose the ability to filter waste, and blood levels of creatinine and urea-nitrogen rise.

Stage IV:

The glomerular filtration rate decreases to less than 75 ml/min, large amounts of protein pass into the urine, and high blood pressure almost always occurs. Levels of creatinine and urea-nitrogen in the blood rise further.

Stage V:

The final stage is ESRD. The glomerular filtration rate drops to less than 10 ml/min. Symptoms of kidney failure occur.


National Kidney and Urologic Diseases Information Clearinghouse (NIDDK) [Web site]. Kidney disease of diabetes. Accessed May 22, 2002. Available at: http://www.niddk.nih.gov/health/kidney/pubs/kdd/kdd.htm.

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