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Hearing the words “you have kidney disease” can stop you in your tracks.
For many people, the diagnosis comes as a complete surprise. You might feel scared, confused, or unsure what it means for your future — and that’s completely normal.
Take a breath.
You don’t have to figure everything out overnight.
The good news is that there’s a lot you can do to protect your kidneys and keep them working well for as long as possible. The first step? Understanding what this diagnosis really means and what practical actions you can start taking today.
How Kidney Disease Is Diagnosed
Chronic kidney disease (CKD) means that your kidneys aren’t filtering quite as efficiently as they used to — and that this change has been present for at least three months.
Doctors typically diagnose CKD when one or both of the following have been found over time:
- A lower estimated glomerular filtration rate (eGFR) — less than 60 for more than 3 months.
- Signs of kidney damage, such as protein in the urine, abnormal imaging, or structural changes.
A single “off” lab result doesn’t necessarily mean you have CKD. Hydration, muscle mass, illness, or even the timing of your lab draw can affect your results. That’s why your provider looks for a consistent trend before making a diagnosis.
From my experience reviewing countless lab panels, this is one of the most common misunderstandings I see. People often panic after one low result when in reality, the kidneys may just be reacting to something temporary — dehydration after travel, a tough workout, or even a fad diet.
What Is eGFR?
Your eGFR (estimated glomerular filtration rate) is one of the main numbers your doctor will watch. It’s calculated using a blood test called creatinine and gives an estimate of how well your kidneys are filtering.
Think of it as a percentage: an eGFR of 90 or higher means your kidneys are filtering normally; an eGFR around 50 means they’re working at about half of their original capacity.
One thing that’s really important to understand about eGFR is that it’s just an estimate. There are many things that can cause this number to move up or down that have nothing to do with real changes in how your kidneys are functioning.
That being said, for many people, eGFR is a reasonably reliable way of tracking kidney function over time — which is why it’s used to determine your stage of kidney disease.
The Stages of Kidney Disease
There are five stages of CKD. In general, the lower your eGFR, the more reduced your kidney function:
Stage 3 CKD
It’s very common to first hear about CKD once you reach stage 3 — not because earlier stages can’t be detected, but because the lab changes can be subtle or overlooked until the numbers drop below 60. With earlier stages, there are many things that can sway the numbers and cause them to appear low, even if kidney function is fine.
I’ll use myself as an example. I once had my eGFR calculated twice in the span of a week due to two different doctors ordering lab work. At the first appointment, my eGFR was completely normal. At the second, it had dropped by 25 points — from 96 down to 71.
Lucky for me, I knew exactly what was different between the two draws (though there was a brief moment of panic before the logical side of my brain took over!).
More importantly, my doctor wasn’t about to label me as having Stage 2 CKD based on that one lab — and yours shouldn’t either. To confirm kidney disease, the eGFR needs to be consistently low and there needs to be another indicator of kidney damage. Otherwise, it could simply be normal variation.
Stage 4 & 5 CKD
If You Were Diagnosed at Stage 4 or 5 — You’re Not Alone
Many people don’t find out they have CKD until the later stages. That doesn’t mean you’ve “missed your chance.” Even at stage 4 or 5, there are meaningful steps you can take to support your kidneys and overall health.
One thing I always remind my patients is this: don’t compare CKD staging to cancer staging. Stage 4 CKD does not mean you’re knocking on dialysis’s door. It simply reflects how much kidney function is left — and there’s still plenty you can do to change the course of your kidney journey.
No matter your stage, it’s never too late to start.
Next Steps After a CKD Diagnosis
Rather than thinking of kidney disease as one big problem to solve, it helps to focus on a few key areas that make the biggest impact.
Find the “Why”
There are many possible causes of kidney disease — diabetes, high blood pressure, autoimmune conditions, medications, or even genetic factors.
Knowing why your kidneys were affected helps you and your care team focus on the right priorities.
Ask your doctor directly:
“What’s the most likely cause of my kidney disease?”
That answer will guide nearly everything else, from your medication plan to your nutrition goals.
Manage What You Can Control
Even if you can’t change the underlying cause, there’s so much you can influence.
- Blood pressure: Keeping readings in a healthy range helps slow further kidney damage.
- Blood sugar: If you have diabetes, maintaining good control is one of the most powerful ways to protect your kidneys.
- Medications: Some medicines — especially pain relievers like ibuprofen or naproxen — can strain the kidneys. Review your medication list regularly with your doctor or pharmacist to make sure everything you take is kidney-safe. Be sure to also mention any supplements that you take, as those can also effect the kidneys.
From my perspective, medication review is one of the most overlooked steps. I’ve seen patients feel discouraged when their eGFR drops, only to later discover a seemingly harmless over-the-counter product (like frequent NSAID use) was contributing. Catching that early can make a huge difference.
Make Nutrition Work for You — Not Against You
A “kidney diet” isn’t something you can just Google once and follow forever — because there isn’t one single diet that fits everyone with CKD.
What you eat should depend on your lab results, your stage of kidney disease, and what else is going on with your health (like blood pressure, diabetes, or heart issues).
The truth is, trying to figure it out on your own can be frustrating — and sometimes even backfires. Many people end up over-restricting foods they don’t actually need to avoid, or missing key nutrients that help protect kidney and heart health.
That’s where a renal dietitian makes all the difference.
A dietitian who specializes in kidney disease can:
• Interpret your lab results and explain exactly how they relate to your diet.
• Show you which foods actually matter for your numbers (and which ones don’t).
• Help you find realistic swaps that fit your lifestyle and food preferences.
• Create a plan that keeps your meals enjoyable — not just “allowed.”
Nutrition is proven to help people with chronic kidney disease.
In fact, there’s so much research behind medical nutrition therapy that insurance companies — including Medicare — often cover visits with a renal dietitian at no out-of-pocket cost.
If you’ve been told “there’s nothing you can do,” please don’t believe that.
Nutrition isn’t about giving up your favorite foods — it’s about learning how to use food to support your kidneys.
Most of my clients tell me they wish they’d worked with a renal dietitian sooner. Once you understand what’s safe, what’s flexible, and what’s actually worth focusing on, food stops being stressful — and starts feeling empowering.
Final Thoughts
A CKD diagnosis can feel like a lot to take in — but remember, it’s not a dead end. It’s a chance to take control of your health, understand your body better, and make changes that truly matter.
If you’re ready to learn how to eat and live in a way that supports your kidneys, I can help.
I’m a board-certified renal dietitian who works with clients one-on-one via telehealth in many U.S. states and accept most major insurance plans. You can book an appointment here. I also offer on-demand courses and resources designed specifically for people with CKD.
Not quite ready to book an appointment or sign up for a course? Join my email list to get to know me a bit better and learn more about CKD nutrition at a pace that works for you.