Stage 2 of Chronic Kidney Disease

A person with stage 2 chronic kidney disease (CKD) has kidney damage with a mild decrease in their glomerular filtration rate (GFR) of 60-89 ml/min. There are usually no symptoms to indicate the kidneys are damaged. Because kidneys do a good job even when they’re not functioning at 100 percent, most people will not know they have stage 2 CKD. If they do find out they’re in stage 2, it’s usually because they were being tested for another condition such as diabetes or high blood pressure – the two leading causes of kidney disease.

  • Physical symptoms. Usually few or no physical symptoms that you can feel (other than those you may experience if you have heavy proteinuria).
  • Blood work. Blood work results will show abnormalities – mainly a slightly elevated serum creatinine. Note that there is often a time lag between elevations of serum creatinine, and some progression of the IgAN. By the time serum creatinine is elevated, the person may already have lost 50% of kidney function.
  • Urinalysis. Urine will show abnormalities. Urine can be checked by dipstick in the doctor’s office (as an initial check), and followed up with a more complete urinalysis. The main urine abnormality that will suggest a kidney disease is the presence of protein and/or blood. Either will usually trigger further investigation. However, blood and/or protein in the urine don’t say anything about actual kidney function.
  • Treatment. Treatment may involve some mild dietary changes (a lower protein diet may in some cases be recommended), and a blood pressure medication may be prescribed (usually of the ACE inhibitor class, the angiotensin II receptor class, or both, even if blood pressure is not really elevated much).
  • Blood pressure. Some people start having high blood pressure even in early chronic renal failure. IgAN is one kidney disease that can do this.
  • Anemia. Anemia may rarely occur at this stage. In this case, it is most often caused by having heavy proteinuria rather than actual chronic renal insufficiency.

Signs of stage 2 kidney disease

Other ways a person may discover they are in stage 2 CKD include:

  • Higher than normal levels of creatinine or urea in the blood
  • Blood or protein in the urine
  • Evidence of kidney damage in an MRI, CT scan, ultrasound or contrast X-ray
  • A family history of polycystic kidney disease (PKD)

Treatment goals

  • Preserve adequate kidney function.
  • Manage any underlying conditions, including diabetes or high blood pressure.
  • Get treatment for existing medical conditions.
  • Reduce the risk of complications.

Treating stage 2 kidney disease

Regular testing for protein in the urine and serum creatinine can show whether the kidney damage is progressing. Living a healthy lifestyle can help slow progression of kidney disease. It’s recommended that people in stage 2 CKD:

  1. Eat a healthy diet
    • Include a variety of grains (especially whole grains), fresh fruits and vegetables.
    • Choose a diet that is low in saturated fat and cholesterol and moderate in total fats.
    • Limit intake of refined and processed foods high in sugar and sodium.
    • Choose and prepare foods with less salt or high-sodium ingredients.
    • Aim for a healthy weight, consume adequate calories and include physical activity each day.
    • Keep protein intake within  a healthy level, as recommended by a renal dietitian.
    • Consume vitamins and minerals as recommended by a doctor.
    • Potassium and phosphorus are usually not restricted unless blood levels are above normal
  2. Keep their blood pressure at a healthy level.
    • 125/75 for those with diabetes
    • 130/85 for non-diabetes and non-proteinuria
    • 125/75 for non-diabetes with proteinuria
  3. Keep their blood sugar or diabetes under control.
  4. Have regular checkups with their doctor and include a serum creatinine test to measure GFR.
  5. Take medicines as prescribed by their doctor.
  6. Exercise regularly.
  7. Stop smoking.

Living with stage 2 kidney disease

There is no cure for kidney disease, but it may be possible to stop its progress or at least slow down the damage. In many cases, the correct treatment and lifestyle changes can help keep a person and their kidneys healthier longer.

If you would like to see a nephrologist (a doctor who specializes in the care of kidneys), pay us a visit at Purivo Dialysis Center. We’re here to help.

What you can do

  • See your doctor about a kidney disease screening blood test and address any other health issues. Most symptoms of CKD don't show up until later stages, if at all, so testing is important.
  • Learn all you can about chronic kidney disease — and consider taking a class.
  • Make healthy lifestyle choices — quit smoking, exercise, eat well, reduce stress and get enough sleep.
  • Take all medications exactly as prescribed.
  • Talk to your doctor before using over-the-counter medications.
  • Check out additional resources for CKD information.
  • Get support from your family, friends, doctor and your counselor, if you have one

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