Being told you have stage 1 kidney disease can be confusing, and you may have a lot of questions. But the good news is that at this early stage, your kidneys are still working well. In this article, we’ll explore what stage 1 kidney disease means and what you can do to protect your kidneys and stay healthy in the long run.

What Is Stage 1 Kidney Disease?

Stage 1 chronic kidney disease (CKD) means your kidneys are still doing their job of filtering waste and extra fluid from your blood, but there are early signs of damage. In stage 1, your estimated glomerular filtration rate (eGFR) is considered normal at 90 or higher. Your eGFR is the measure of how well your kidneys filter waste from the blood. It is calculated based on the amount of creatinine (waste product) in your blood, your age, and your biological sex.

If your eGFR is normal, there are still other signs of possible kidney damage, like proteinuria (protein leaking into your urine). Doctors are able to test how much protein is in your urine, and it is normal to have a very tiny amount. When more than the usual amount of protein — specifically the protein albumin — is found in your urine, it is called albuminuria.

The more your kidneys are damaged, the more protein can be found in your urine. However, having protein in your urine does not automatically mean you’ll be diagnosed with stage 1 kidney disease. Other factors, like the structure or shape of your kidneys, may also play a role. Also, people sometimes have extra protein in their urine after intense exercise or a fever, or if they’re dehydrated or have other health conditions. Repeated tests are usually necessary to confirm if a person has kidney disease.

Diagnosing Stage 1 Kidney Disease

Doctors may use blood pressure checks, urine tests, or imaging tests to assess your kidney health, especially if you have a family history of kidney disease or another health condition like diabetes or high blood pressure, which may cause damage to the kidneys.

A urine albumin-to-creatinine ratio (uACR) test is a common and accurate test that looks at the amount of albumin in your urine compared to the amount of creatinine. A high uACR means that your kidneys are leaking albumin, which is a sign they’re not working quite right.

The risk of kidney failure increases as the uACR value rises. A uACR value between 30 and 300 milligrams of albumin per gram of creatinine is known as microalbuminuria. If the value is greater than 300 milligrams per gram, it is known as macroalbuminuria. Your doctor may perform repeat tests to ensure that the changes in the uACR values are not due to normal variations caused by factors that include:

• Your race
• Your biological sex
• The amount of water food and salt you have recently consumed
• The presence of urinary tract infections

They will ask for repeated testing within three months of the initial test.

Early Symptoms: What You Might (or Might Not) Notice

Most people with stage 1 kidney disease don’t feel sick or notice any symptoms. That’s why it’s often called a “silent” condition and can go unnoticed. However, doctors may spot signs during routine checkups or tests for other health issues.

Some signs that may show up include:

• Hypertension (high blood pressure), which is a common cause and effect of kidney disease
• Proteinuria (protein in your urine)
• Hematuria (blood in your urine)
• Swelling in your feet or hands
• Frequent urinary tract infections
• Kidney changes detected through imaging tests

If your kidney disease starts to get worse, you might begin to notice symptoms like fatigue, swelling, changes in how often you urinate, or shortness of breath. These symptoms, which occur in later stages of kidney disease, can be a sign that your kidneys are having a harder time doing their job.

Rare Types of Kidney Disease

While most kidney disease is caused by conditions like diabetes or high blood pressure, some people have rare types. Two examples are complement 3 glomerulopathy (C3G) and immune complex membranoproliferative glomerulonephritis (IC-MPGN). These diseases happen when part of your immune system, called the complement system, is overactive and causes harmful C3 proteins and immune complexes to build up in your kidneys. Over time, this can lead to damage and reduced functioning in the kidneys.

People with C3G or IC-MPGN may have symptoms like protein or blood in their urine, swelling, high blood pressure, and fatigue. These conditions are rare and often need a kidney biopsy, or tissue sample, to diagnose.

What You Can Do To Protect Your Kidneys

Even though stage 1 kidney disease may not cause symptoms, it’s important to take action now to protect your kidneys from progressing to stage 2 kidney disease and beyond. You can find a nephrologist (a doctor who specializes in kidney diseases) or ask your primary care physician for a referral. Keep in mind that you can’t reverse kidney disease, but there are a few steps you can take:

1. Eat a Kidney-Friendly Diet

A healthy diet can help slow kidney damage. While there are no specific dietary restrictions for stage 1 kidney disease, you should still try to:

• Eat more fruits and vegetables.
• Choose whole grains.
• Limit salt, added sugars, and processed foods.
• Choose lean proteins like chicken, fish, or beans.

Your healthcare provider can help create a meal plan that’s right for you or refer you to a dietitian.

2. Stay Active

Exercise helps to improve your energy and blood pressure, both of which are important for kidney health. Aim for at least 30 minutes of physical activity at least three days a week. You could try activities like walking, biking, strength training, or even dancing.

3. Maintain a Healthy Weight

Keeping a healthy weight can be good for your health in a number of ways. A healthy weight can look different for everyone, so be sure to talk to your doctor about what is right for you.

4. Quit Smoking

Smoking can make kidney disease worse and put you at risk for health conditions like kidney failure, heart disease, high blood pressure, stroke, and certain cancers. If you currently smoke, you can ask your doctor for help quitting.

5. Be Mindful of Alcohol Intake

Responsible alcohol use is not usually directly harmful to the kidneys, and if you have stage 1 kidney disease, it doesn’t have to be a primary concern (though you should still consider alcohol’s impact on your overall health). That said, alcohol can have some effects that indirectly worsen kidney disease. For example, it could interfere with the actions of some of the medications you may be taking to protect your kidneys. It could also raise your blood pressure, which is not good for the kidneys in the long term.

6. Manage Other Health Conditions

If you have high blood sugar, diabetes, or hypertension, keeping them under control is one of the best ways to protect your kidneys. Your doctor may also prescribe medications to help protect your kidneys, depending on your specific conditions. It is important to talk with your doctor if you are taking any over-the-counter pain medicines like nonsteroidal anti-inflammatory drugs (NSAIDs), vitamins, or herbal supplements.

7. Get Regular Checkups

Even if you feel fine, regular healthcare visits to see your doctor are important. They can check your kidney function and make changes to your care plan if needed.

Talk With Others Who Understand

MyKidneyDiseaseTeam is the social network for people with kidney disease and their loved ones. On MyKidneyDiseaseTeam, members come together to ask questions, give advice, and share their stories with others who understand life with kidney disease.

What did you learn about stage 1 kidney disease? What lifestyle changes have you made to reduce your risk of kidney disease progression? Comment below, or start a new conversation on your Activities page.