Disease Stage Action Guide
Know which stage you are in and what to do about it
⚠ Medical Safety Notice
This guide is compiled based on the KDIGO 2025 ADPKD Guideline and the 2024 Chinese ADPKD Diagnosis and Treatment Guideline, and is for health education reference only. Staging is determined by a doctor based on test results — do not self-diagnose. All action suggestions should be combined with your individual situation and discussed with your nephrologist.
Step 1 — Determine Which Stage You Are In
The course of ADPKD is usually classified by CKD (chronic kidney disease) stage, using eGFR (estimated glomerular filtration rate) as the standard. Staging is calculated by a doctor from blood test results — do not determine it yourself.
| CKD Stage | eGFR (mL/min) | Kidney Function Status | Common Manifestations |
|---|---|---|---|
| G1 (Early) | ≥ 90 | Normal or hyperfiltration | Usually asymptomatic; possible hypertension, hematuria |
| G2 (Mild) | 60–89 | Mildly decreased kidney function | Rising blood pressure, increasing TKV, microalbuminuria |
| G3a (Mild–moderate) | 45–59 | Mild-to-moderate decline | Electrolytes begin to become abnormal; PTH may rise |
| G3b (Moderate–severe) | 30–44 | Moderate-to-severe decline | Anemia appears; intensified monitoring needed |
| G4 (Severe) | 15–29 | Severely decreased kidney function | Electrolyte disorders, anemia, bone disease |
| G5 (Kidney failure) | < 15 | End-stage renal disease | Dialysis or transplantation required |
For how staging is determined and how to interpret test indicators, see Diagnosis & Testing and Lab Indicators Explained.
Step 2 — Understand the Core Goals of Your Stage
- G1–G2 (Early stage): Preserve kidney function and slow disease progression. The core is blood pressure control, assessing whether tolvaptan is needed, and establishing a monitoring baseline.
- G3a–G3b (Middle stage): Manage complications and maintain kidney function. The core is anemia management, bone and mineral metabolism management, and adjusting diet and medications.
- G4–G5 (Late stage): Prepare for kidney replacement therapy and maintain quality of life. The core is dialysis/transplant preparation, strict complication management, and psychological support.
Step 3 — What to Do at Your Stage (Action Checklist)
G1–G2 (Early stage, eGFR ≥ 60)
Core goal: Preserve kidney function and slow progression
- Regular checkups: blood pressure every 3 months, eGFR yearly, TKV every 1–2 years, UACR yearly → Lab Indicators Explained
- Blood pressure control: target < 130/80 mmHg → Hypertension Management
- Low-sodium diet: < 5 g salt per day → Diet Guide
- Regular exercise: moderate-intensity aerobic activity → Fitness Guide
- Avoid nephrotoxic drugs: NSAIDs, herbs containing aristolochic acid → Lifestyle
- Genetic counseling: if you have family planning needs → Family Planning
- Psychological adjustment: accept the disease and manage it actively → Mental Health
- Tolvaptan assessment: high-risk patients (large TKV, fast eGFR decline) may consider it → Treatment Options
Sources: KDIGO 2025 ADPKD Guideline; Chinese ADPKD Diagnosis and Treatment Guideline 2024
G3a–G3b (Middle stage, eGFR 30–59)
Core goal: Manage complications and maintain kidney function
- Intensified monitoring: eGFR every 3–6 months, electrolytes every 6 months, PTH/iron metabolism/hemoglobin → Lab Indicators Explained
- Anemia assessment: check hemoglobin, iron metabolism, EPO → EPO indicator
- Bone and mineral metabolism management: monitor PTH, calcium, phosphorus → PTH indicator
- Adjust diet: restrict phosphorus/potassium intake → Diet Guide (G3 plan)
- Adjust exercise intensity: avoid high-intensity activity → Fitness Guide (G3 plan)
- Vaccinations: influenza, pneumococcal, hepatitis B → Lifestyle
- Address daily discomforts: flank pain, nocturia, fatigue → Daily Symptoms Management
- Medication adjustments: some drugs require dose reduction (consult your doctor)
Sources: KDIGO 2025 ADPKD Guideline; KDIGO CKD-MBD Guideline
G4–G5 (Late stage, eGFR < 30)
Core goal: Prepare for kidney replacement therapy and maintain quality of life
- Intensive monitoring: eGFR, electrolytes, hemoglobin every 1–3 months → Lab Indicators Explained
- Prepare for kidney replacement therapy: learn about dialysis and transplantation → Treatment Options
- Evaluate dialysis modality: hemodialysis vs. peritoneal dialysis
- Transplant evaluation: living-related donor vs. deceased donor
- Strict diet management: restrict potassium/phosphorus/sodium/protein → Diet Guide (G4–G5 plan)
- Monitor cardiovascular risk: ECG, echocardiography
- Strengthen psychological support: prepare emotionally for dialysis/transplant → Mental Health
- Avoid nephrotoxic drugs: nearly all medications require doctor evaluation
Sources: KDIGO 2025 ADPKD Guideline; Chinese ADPKD Diagnosis and Treatment Guideline 2024
Step 4 — Daily Management Tools
The following tools help you manage the disease day to day. All data is stored locally in your browser and is never uploaded to the cloud.
The Role of Different Medical Approaches at Each Stage
| Stage | Conventional Medicine Core | TCM Adjunct Role | Integrated Approach |
|---|---|---|---|
| G1–G2 | Blood pressure control + tolvaptan | Symptom relief (flank pain/insomnia) | Conventional medicine primary, TCM for symptom support |
| G3 | Complication management | Dietary therapy adjunct + acupuncture for pain | Conventional medicine primary, TCM to improve quality of life |
| G4–G5 | Dialysis/transplantation | Oral TCM not recommended | Strict conventional medicine; TCM only external therapies |
For a detailed comparison of the pros, cons, and approaches of each medical tradition, see Comparing Medical Approaches.
Limitations: This content Individual circumstances vary greatly — always consult your nephrologist. Reference ranges may differ between laboratories.
References
- KDIGO 2025 Clinical Practice Guideline on the Evaluation and Management of ADPKD — KDIGO. Kidney International, 2025. DOI: 10.1016/j.kint.2024.07.010. View source
- Chinese Guideline for the Diagnosis and Management of Autosomal Dominant Polycystic Kidney Disease (2024 Edition) — Chinese Society of Nephrology. Chinese Journal of Nephrology, 2024. View source
- KDIGO 2023 CKD-MBD Clinical Practice Guideline — KDIGO. Kidney International, 2023. View source
- ERA-EDTA Recommendations for ADPKD Management — ERA-EDTA Working Group. Nephrology Dialysis Transplantation, 2023. View source