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Hello welcome to chronic kidney disease program at University of California San Diego my name is Dan with Sabine Scott and I'm a nephrologist in our clinic in this module we are going to talk about the different stages of chronic kidney disease chronic kidney disease is quite common it affects 11% of u.s. population which translates to about 30 million people another 30 million people are at risk for developing CJD at some point in their lives ideally we would like to prevent individuals from developing CKD in the first place but unfortunately that is not always possible early detection is the second best option in order to take appropriate actions to slow down the decline of kidney function let's talk about estimating kidney function it's usually not as precise or easy as checking your weight or even measuring electrolyte levels in your blood doctors nurses pharmacists use special equations to ekidney function based on the level of creatinine in the blood what is creatinine well creatinine is a waste product generated by muscle metabolism and removed or excreted if you will from the body by kidneys the higher the creatinine level in the blood the less efficient kidneys are at removing it from the body so the worse the level of kidney function is the term for the level of kidney function is glomerular filtration rate or GF r GFR is the rate at which kidneys filter toxins from the blood this number also correlates with overall kidney function we stage kidney disease or assign severity based on the GFR it is extremely important that you know your GFR in simple terms you can think of GFR as a percentage of normal kidney function for example GFR 40 means that your overall kidney function yes for both kidneys is about 40 percent of normal please remember it is just an eand not a true measure of your kidney function also you need to realize that GFR fluctuates from day to day just like your blood pressure does or stock market does so we look at the trend and not necessarily every individual value will now go over stages of chronic kidney disease there are five of them with one being the least severe and five being the most severe in stage one chronic kidney disease GFR is relatively preserved greater than ninety so it's considered normal or close to normal yet there are some other markers of kidney disease for example there's protein in the urine and we'll talk more about this a little bit later so that's stage one chronic kidney disease in stage two CKD GFR is mildly reduced to between 60 and 89 and there are some other markers of kidney injury most of the time it's protein again you will see that protein is important now stage 3 this is the middle route kidney disease and also the most common category GFR in CKD three is moderately reduced is between 30.