Kidney Patient Information for your CKD journey - from diagnosis upwards.

Most people with CKD are diagnosed through two simple tests: a blood test that measures a protein called creatinine, and a urine test that looks for protein or blood that should not be there. Your GP or consultant uses the creatinine result to work out your estimated glomerular filtration rate, or eGFR, which is essentially a score for how well your kidneys are filtering. A normal eGFR sits around 90 or above. A persistent result below 60, measured at least twice three months apart, confirms chronic kidney disease.

Being told you have CKD can feel like a door slamming. In reality your team is telling you early, so that together you can protect the kidney function you still have. CKD is a spectrum, not a single destination. Many people live full lives for decades at mild stages and never progress.

From a patient point of view, the first week is usually the hardest. You will have questions the clinic did not have time for. Write them down. Bring them to the next appointment. Ask about your exact eGFR number, your urine ACR result, your blood pressure target, and any medicines that might need reviewing. The NHS page on kidney disease is a solid starting point for the medical basics; we have kept our own patient journey overview deliberately short and human for the same first-week feeling.

Stage 1 means an eGFR of 90 or more, but with other signs that your kidneys have been damaged, for example protein in the urine, a known structural problem like polycystic kidney disease, or diabetes-related changes. Stage 2 means an eGFR between 60 and 89 with similar signs. At this point the kidneys are still doing most of their job. You may feel completely well, and you might not need any specific kidney treatment yet.

What matters most at this stage is protecting the kidney function you still have. That means managing blood pressure, looking after blood sugar if you have diabetes, stopping smoking, staying at a healthy weight, and being thoughtful about medicines that can irritate the kidneys, including common over-the-counter anti-inflammatories like ibuprofen. Kidney Care UK’s early-stage CKD guidance is excellent on the day-to-day detail.

From a patient perspective, early CKD is the stage where the lifestyle work pays off the most and the hardest to take seriously, because you feel fine. Our healthy living tips for kidney patients page collects the habits MRIKPA members say have made the biggest difference for them. None of them are dramatic. They are small, steady, Manchester-friendly.

Stage 3 is split into 3a (eGFR 45 to 59) and 3b (eGFR 30 to 44). This is the stage at which many people first meet a kidney specialist. You may be referred to the renal team at Manchester Royal Infirmary or your local hospital for closer monitoring. Regular blood tests will track your eGFR, potassium, phosphate, haemoglobin and bone chemistry. If protein in the urine is high, your team will usually start or optimise medicines that protect the kidneys, such as an ACE inhibitor, an angiotensin-II receptor blocker, or one of the newer SGLT2 inhibitors that are now recommended for CKD by NICE guideline NG203.

Stage 3 is also when tiredness, restless legs, or feeling “not quite right” can first show up. Kidney Research UK’s stage 3 CKD page is a useful readable summary.

From the patient side, this is the stage where our WhatsApp group and our Casual Park Walks become especially useful. You are well enough to live normally, but you have started to realise that kidney disease is going to be part of your life. Talking to people who have already been where you are now helps more than most things. Our Park Walks are gentle by design and built for exactly this.

Stage 4 means an eGFR between 15 and 29. Kidney function is now significantly reduced, and the chances of reaching kidney failure in the foreseeable future are real enough that your team will start preparing with you. This is usually called “pre-dialysis” or “low clearance” care. You will be seen more often, usually at a dedicated kidney clinic, and conversations about treatment options begin in earnest.

The three broad options are: a kidney transplant, either from a living donor or from the deceased-donor waiting list; dialysis, which can be done in a hospital unit, at a satellite unit, or in your own home; and conservative kidney management, which is supportive care without dialysis, usually chosen by older patients with other serious health conditions. None of these is a failure. They are three different ways to live well with kidneys that can no longer do the job alone.

From a patient perspective, stage 4 is often the stage where we most need other patients. At MRIKPA we match people, informally and confidentially, with members who have been through the same decision. There is no right answer, only the right answer for you. Our renal care at MRI page explains what is available locally.

Stage 5, sometimes called established kidney failure or end-stage renal disease, is an eGFR below 15. At this level the kidneys can no longer meet the body’s needs on their own and a form of kidney replacement therapy is usually required. The language here is frightening, but the reality is more manageable than it sounds. Many people start dialysis feeling cautiously relieved, because the months before it often involve a creeping fatigue that lifts once treatment begins.

A small number of people reach stage 5 without needing urgent treatment, because they have already had a pre-emptive transplant from a living donor. Others start dialysis as a bridge to transplant. Others choose conservative care. Kidney Care UK’s overview of the stages of CKD is good at making the numbers feel less abstract.

The patient truth is that stage 5 is hard, and it is also survivable, and most people find a routine that works. MRIKPA members who are on dialysis, or who have been transplanted, are some of the most generous people you will meet. They will tell you what nobody in clinic has time to say. Drop us a message via our contact page if you would like to be put in touch.

Dialysis does the filtering job your kidneys can no longer do. There are two broad types. Haemodialysis pumps your blood through a machine that cleans it, typically three times a week for around four hours per session. It can be done at Manchester Royal Infirmary’s renal unit, at a satellite unit closer to home, or for the right patients in their own home as home haemodialysis. Peritoneal dialysis uses the lining of your own abdomen as a filter; fluid is run in and out through a small tube, either by hand several times a day (CAPD) or overnight by a machine while you sleep (APD). The National Kidney Federation’s peritoneal dialysis guide is a practical read.

Vascular access matters. For haemodialysis this is usually an arteriovenous fistula, made by a small operation several months before dialysis is expected to start. For peritoneal dialysis it is a soft catheter in the abdomen. Your team will plan this well in advance so that dialysis can start smoothly when it is needed.

From the patient side, choosing a modality is one of the most personal decisions in the whole journey. Haemodialysis at a unit gives you structure and a friendly team around you. Home dialysis, whether haemo or peritoneal, gives you flexibility and freedom for work, travel and family. There is a cost of living alongside either, and a MRIKPA member who has already chosen is often the best person to talk to. Our about dialysis page goes deeper into the day-to-day of each option.

A kidney transplant is the treatment most people consider the gold standard for end-stage kidney disease, because a well-functioning transplant can restore normal energy and remove the need for dialysis. Transplants come from two sources in the UK: a living donor, usually a relative, partner or friend, or a deceased donor through the NHS organ donor register, managed by NHS Blood and Transplant.

Getting onto the transplant list involves a thorough assessment: heart and lung tests, cancer screening, dental and skin checks, blood group and tissue typing. The wait for a deceased-donor kidney varies, but it is typically measured in years, which is why pre-emptive living-donor transplants, done before dialysis starts, are so valuable when they are possible. Across Black, Asian and minority ethnic communities the wait is often longer because fewer donors come forward, which is why community-led conversations really matter; we keep a page on organ donation in BAME communities as a starting point.

The patient truth is that a transplant is a second chance, not a cure. It comes with lifelong immunosuppressant medicines, regular clinic visits, and careful attention to skin cancer screening, blood pressure, and bone health. It is also, for most recipients, life-changing in the best way. Many of our members have completed in the British Transplant Games after recovery; that page is a good window into what life after transplant can look like.

Life after a successful kidney transplant tends to settle into a new normal within a few months. The first year involves frequent clinic visits and blood tests as your team fine-tunes your immunosuppressant doses. After that, most recipients settle into a routine of less frequent monitoring, an emphasis on healthy eating, activity, sun protection, and staying up to date with vaccines. A transplanted kidney does not last forever, but with good care many kidneys function well for 15, 20 or more years.

For those who do not have a transplant, long-term life on dialysis is equally real and equally full. Working patterns, travel, hobbies and family life can all be adapted. The NKF’s haemodialysis treatment frequency guide and Kidney Care UK’s information on managing symptoms are both worth keeping bookmarked.

From the patient side, the long term is where MRIKPA earns its keep. Kidney disease can be lonely. Renal clinics are busy, friends and family can struggle to understand the tiredness or the diet, and life carries on regardless. Our Casual Park Walks, our WhatsApp group, and our members’ events are built to make sure no Manchester kidney patient has to do this alone. If you are newly diagnosed, or ten years into dialysis, or five years post-transplant, the welcome is the same.