CKD stages at a glance
| Stage | eGFR (ml/min/1.73 m²) | Description |
|---|---|---|
| G1 | ≥ 90 | Normal kidney function |
| G2 | 60–89 | Mildly decreased |
| G3a | 45–59 | Mild–moderate CKD |
| G3b | 30–44 | Moderate–severe CKD |
| G4 | 15–29 | Severely decreased |
| G5 | < 15 | Kidney failure (dialysis/transplant) |
CKD diagnosis also depends on persistence (≥ 3 months) and signs of kidney damage (urine albumin/creatinine ratio, abnormal imaging, biopsy).
Why CKD matters in Pakistan
CKD prevalence is rising in Pakistan, driven mainly by the high burden of diabetes and uncontrolled hypertension. Early stages are usually silent — diagnosis is by blood test, not symptoms. Catching CKD early lets you slow progression by treating BP and diabetes well, avoiding nephrotoxic medicines (especially long-term NSAIDs), and adjusting medication doses correctly.
FAQ
What is eGFR?
Estimated Glomerular Filtration Rate (eGFR) is a number that estimates how well your kidneys filter waste from blood. It is calculated from a serum creatinine blood test along with age and sex. eGFR is reported in millilitres per minute per 1.73 m² of body surface area.
What is a normal eGFR?
An eGFR of 90 ml/min/1.73 m² or above is considered normal kidney function (in the absence of other markers of kidney damage). eGFR naturally declines slightly with age. Two readings 3 months apart that show eGFR < 60 confirm chronic kidney disease (CKD).
What does my CKD stage mean?
G1 (≥90) is normal; G2 (60–89) is mildly decreased; G3a (45–59) is mild-to-moderate CKD; G3b (30–44) is moderate-to-severe; G4 (15–29) is severely decreased; G5 (<15) is kidney failure requiring renal replacement therapy. Staging guides how often you need monitoring and which medicines need dose adjustment.
Why CKD-EPI 2021 instead of older formulas?
The CKD-EPI 2021 equation is the modern race-free standard recommended by the National Kidney Foundation, NICE, and most international nephrology bodies. It removed the race coefficient used in older equations (MDRD, CKD-EPI 2009), which is more equitable and clinically accurate.
What can affect eGFR readings?
Creatinine — and so eGFR — can be affected by muscle mass (large body builders have higher creatinine, so eGFR may be underestimated), recent meat intake (a heavy meaty meal can transiently raise creatinine), severe dehydration, certain medicines (trimethoprim, cimetidine), and acute illness. CKD diagnosis requires persistence over ≥3 months.
Should I avoid any medicines if my eGFR is low?
Several common medicines need dose adjustment or avoidance with reduced eGFR — including NSAIDs (Brufen, Voren, Synflex), certain antibiotics (gentamicin, vancomycin), metformin (avoid below ~30), some statins, and diabetes medicines. Always tell every doctor and pharmacist about your eGFR. CT contrast scans need extra precautions when eGFR is low.