Stage 1: Normal function, kidney damage present
What it means
At Stage 1, your filtration rate is normal — but there’s evidence that the kidneys have been injured in some way. The most common signs are protein (albumin) showing up in the urine, structural changes seen on imaging, or a known diagnosis like polycystic kidney disease or lupus that affects the kidneys. Most people at this stage feel completely fine, which is why a Stage 1 label often comes as a surprise.
Catching kidney disease this early is genuinely good news. The kidneys are still doing their job, and the changes that have started can often be slowed, stabilized, or — in some cases — reversed.
How it’s usually found
- A routine urinalysis showing albumin or protein
- An incidental finding on an ultrasound or CT done for something else
- Family screening when a hereditary kidney condition runs in the family
- A diabetes or high-blood-pressure workup that includes a urine albumin check
What’s happening in your body
Your kidneys are made up of about a million tiny filtering units called nephrons. When some are damaged, the remaining ones work a little harder to keep things in balance — what nephrologists call hyperfiltration. That’s why your GFR looks normal on the lab report even though damage is there. Over time, that extra workload can speed up wear on the rest of the kidneys if the underlying cause isn’t addressed.
What your care team focuses on
- Treating the cause. Diabetes, blood pressure, glomerulonephritis, lupus, polycystic disease — each has its own playbook. The single most powerful thing we do at Stage 1 is tackle whatever is driving the kidney damage.
- Blood pressure control. For most people with CKD and albuminuria, many nephrologists aim for less than 130/80.
- An ACE inhibitor or ARBwhen there’s protein in the urine. These medications gently lower the pressure inside the kidney filters and reduce protein leakage — a real protective effect.
- An SGLT2 inhibitorin many cases. This newer class of medication has become standard of care for CKD with albuminuria, including for people who don’t have diabetes.
- Lifestyle. Lower-sodium eating, no smoking, moving your body most days, and staying close to a healthy weight all matter — quietly and consistently.
Questions patients often ask
Questions for your next visit
- What’s the underlying cause of my kidney damage, and what’s our plan to treat it?
- Is my blood pressure where you’d like it to be for protecting my kidneys?
- Is there protein in my urine, and is it changing over time?
- Are any of my current medications hard on my kidneys?
- What lab schedule do you recommend, and when do we look at it together?
Related reading
The honest summary of Stage 1: you caught something early, and that’s the best place to start a long, well-managed relationship with your kidneys.
Compare across stages
A quick snapshot of every stage side-by-side.
| Stage | GFR (mL/min) | What it means | Visit cadence |
|---|---|---|---|
| Stage 1Current stage | ≥ 90 | Normal function with signs of damage | Every 6–12 months |
| Stage 2 | 60 – 89 | Mild drop in function | Every 6–12 months |
| Stage 3 | 30 – 59 | Moderate drop; lab changes appear | Every 3–6 months |
| Stage 4 | 15 – 29 | Severe drop; planning for next steps | Every 1–3 months |
| Stage 5 | < 15 | Kidney failure; needs replacement therapy or supportive care | Monthly (or per dialysis schedule) |
This information is for education only and doesn't replace advice from your care team.