Disease Stage Action Guide
Know which estadio 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 nefrólogo.
Step 1 — Determine Which Stage You Are In
The course of ADPKD is usually classified by CKD (enfermedad renal crónica) estadio, using eGFR (tasa de filtración glomerular estimada) 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 hyperfiltración | Usually asíntomaatic; possible hipertensión, hematuria |
| G2 (Mild) | 60–89 | Mildly decreased función renal | Rising presión arterial, 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 monitoreo needed |
| G4 (Severe) | 15–29 | Severely decreased función renal | Electrolyte disorders, anemia, bone disease |
| G5 (Kidney failure) | < 15 | End-estadio renal disease | Dialysis or trasplanteation 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 estadio): Preserve función renal and slow disease progresión. The core is presión arterial control, assessing whether tolvaptán is needed, and establishing a monitoreo baseline.
- G3a–G3b (Middle estadio): Manage complicacións and maintain función renal. The core is anemia management, bone and mineral metabolism management, and adjusting diet and medicamentos.
- G4–G5 (Late estadio): Prepare for terapia de reemplazo renal and maintain calidad de vida. The core is diálisis/trasplante preparation, strict complicación management, and psychological apoyo.
Step 3 — What to Do at Your Stage (Action Checklist)
G1–G2 (Early estadio, eGFR ≥ 60)
Core goal: Preserve función renal and slow progresión
- Regular checkups: presión arterial 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-sodio diet: < 5 g salt per day → Diet Guide
- Regular ejercicio: moderate-intensity aerobic activity → Fitness Guide
- Avoid nefrotóxico drugs: NSAIDs, herbs containing ácido aristolóquico → 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-riesgo pacientes (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 estadio, eGFR 30–59)
Core goal: Manage complicacións and maintain función renal
- Intensified monitoreo: eGFR every 3–6 months, electrolytes every 6 months, PTH/iron metabolism/hemoglobina → Lab Indicators Explained
- Anemia assessment: check hemoglobina, iron metabolism, EPO → EPO indicator
- Bone and mineral metabolism management: monitor PTH, calcio, fósforo → PTH indicator
- Adjust diet: restrict fósforo/potasio intake → Diet Guide (G3 plan)
- Adjust ejercicio intensity: avoid high-intensity activity → Fitness Guide (G3 plan)
- Vaccinations: influenza, pneumococcal, hepatitis B → Lifestyle
- Address daily discomforts: dolor en el flanco, nicturia, fatiga → Daily Symptoms Management
- Medication adjustments: some drugs require dose reduction (consulte a su médico)
Sources: KDIGO 2025 ADPKD Guideline; KDIGO CKD-MBD Guideline
G4–G5 (Late estadio, eGFR < 30)
Core goal: Prepare for terapia de reemplazo renal and maintain calidad de vida
- Intensive monitoreo: eGFR, electrolytes, hemoglobina every 1–3 months → Lab Indicators Explained
- Prepare for terapia de reemplazo renal: learn about diálisis and trasplanteation → Treatment Options
- Evaluate diálisis modality: hemodiálisis vs. diálisis peritoneal
- Transplant evaluation: living-related donor vs. donante fallecido
- Strict diet management: restrict potasio/fósforo/sodio/proteína → Diet Guide (G4–G5 plan)
- Monitor cardiovascular riesgo: ECG, echocardiography
- Strengthen psychological apoyo: prepare emotionally for diálisis/trasplante → Mental Health
- Avoid nefrotóxico drugs: nearly all medicamentos 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 + tolvaptán | Symptom relief (dolor en el flanco/insomnia) | Conventional medicine primary, TCM for síntoma apoyo |
| G3 | Complication management | Dietary therapy adjunct + acupuntura for pain | Conventional medicine primary, TCM to improve calidad de vida |
| G4–G5 | Dialysis/trasplanteation | 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 consulte a su nefrólogo. 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 Polyquisteic 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