Patient guide
Chronic Kidney Disease (CKD)
A CKD diagnosis is not a countdown. With the right care, most people can slow it down — and many never need dialysis.
What is CKD?
Your kidneys are filters. Every day they clean about 150 quarts of blood, removing waste and extra fluid. Chronic kidney disease means those filters have been damaged and are slowly losing power — usually over years, not weeks.
CKD is graded in five stages based on a blood test number called eGFR. Think of eGFR as your kidneys' score out of 100:
| Stage | eGFR | What it means |
|---|---|---|
| 1 | 90+ | Kidney damage signs, but normal filtering power |
| 2 | 60–89 | Mild loss of filtering power |
| 3 | 30–59 | Moderate loss — the most important time to act |
| 4 | 15–29 | Severe loss — time to plan ahead together |
| 5 | Below 15 | Kidney failure — dialysis or transplant territory |
Most CKD is caused by diabetes or high blood pressure. It usually has no symptoms until late stages — which is why acting on an early lab result matters so much.
When should you see a kidney specialist?
- Your eGFR is below 60 — or it's dropping quickly between tests
- Your urine tests show protein or blood
- You have diabetes or high blood pressure and abnormal kidney numbers
- Your doctor said "stage 3" or higher — a nephrologist visit is worth it at stage 3, not just stage 4
- Kidney disease runs in your family
Seeing a nephrologist early is linked to slower disease and better outcomes. You do not need to wait until things are serious — early is exactly when we can help most.
How we treat CKD
We can't cure CKD, but we can often slow it dramatically. Your plan may include:
- Blood pressure control — the single biggest protector of kidneys
- Kidney-protecting medicines — including newer drugs that have changed CKD care in the last few years
- Blood sugar management if you have diabetes, alongside your other doctors
- Food guidance — practical advice on salt, potassium, phosphorus, and protein
- Avoiding kidney harms — like certain pain relievers and dye used in some scans
- Treating side effects such as anemia and bone-mineral problems
If your CKD ever advances, we'll walk with you through dialysis planning or transplant referral — early, calmly, and on your terms.
What to expect at your visit
Your first CKD visit takes about an hour. Dr. Lal reviews your labs and medicines, examines you, and explains your stage and trend in plain words. You'll leave with a written plan: your target numbers, your medicines, and when we'll recheck. Follow-ups are usually every 3–6 months, and many can be done by telehealth.
See what to bring to your first visit →
Sources for this guide include the National Kidney Foundation and KDIGO clinical guidelines. This page is general education, not personal medical advice.
If this is an emergency, call 911. Sudden inability to urinate, severe swelling with trouble breathing, or chest pain need emergency care now.
Told you have CKD? Let's protect what you have.
Dr. Lal is accepting new CKD patients at both offices. Bring your labs — we'll explain every number.
Request an AppointmentOr call (903) 841-4454