What are the stages of ADPKD?

If you have kidney damage and/or a decrease in kidney function for three or more months, it is called chronic kidney disease (CKD). There are five stages of CKD, with progressive symptoms.

Stages of CKD 

Stage 1

Includes signs of mild kidney disease, with a normal GFR showing 90 percent or higher kidney function.

Stage 2

Includes signs of mild kidney disease with a GFR showing 60–89 percent kidney function.

Stage 3

Includes signs of moderate kidney disease and a GFR showing 30–59 percent kidney function. 

Stage 4

Includes signs of severe kidney disease and GFR showing 15–29 percent kidney function.

Stage 5

Includes signs of severe kidney disease and kidney failure, with a GFR showing less than 15 percent kidney function.


These indicators can occur in all stages

  • May have some blood in urine
  • May have urinary tract infections (UTIs)
  • May have kidney stones
  • Can have aneurysms in brain

Treatment options to discuss with your doctor

  • Limit protein intake
  • Limit salt intake
  • Consider hypertension medication


The stages of CKD in PKD have specific indicators

PKD Stages 1–2
  • Few physical symptoms
  • Labs may show slightly elevated creatinine
PKD Stages 3–4

May have no physical symptoms or may have:

  • Fatigue
  • Back pain
  • Puffiness or swelling
  • Loss of appetite
  • Food may taste funny
  • Hypertension
  • Abdominal swelling
PKD Stage 5

Physical symptoms include:

  • Anemia
  • Weak, tired, drowsy
  • Headaches
  • Confusion, difficulty concentrating
  • Nausea, vomiting, decreased appetite
  • Itching
  • Muscle cramps
  • Swelling and puffiness
  • Shortness of breath
  • Hypertension
  • Change in skin color (grayish or yellowish)
  • Women may experience changes in menstrual cycle

    How can I tell if my kidneys have failed?

    End-stage renal disease (ESRD) is when normal kidney function declines and needs to be replaced by dialysis or transplant. This is also known as kidney failure. At this point, GFR is at 10 or less, and kidneys can no longer balance electrolytes and acids in the blood or remove wastes and excess water.

    Symptoms that some people experience during this time could include:

    • Decreased energy
    • Weakness
    • Shortness of breath
    • Weight loss
    • Nausea and/or vomiting
    • Metallic taste in the mouth
    • Mild to moderate depression
    • Decreased ability to think problems through

    It is important to keep your doctor informed of your symptoms so she/he can help you decide when it’s time to start dialysis or be evaluated for transplant.

    Blood tests will show that your blood urea nitrogen (BUN) and creatinine are not being properly eliminated by the kidneys and are building up in the blood. These tests may also show that your electrolytes and pH are out of balance.

    Generally, planning for kidney replacement therapy (dialysis) is done when your kidney function is at about 25 percent. If you wait until you are very sick, it will take you much longer to recover and may require hospitalizations.

    Page last reviewed June 2021