The terms chronic kidney disease (CKD) and kidney failure are often heard together, leading to understandable confusion within the community. While related, these terms represent different stages of a person’s kidney health journey.
Understanding the distinction is crucial for early detection, proper management, and better health outcomes for the millions affected by these conditions worldwide, including those in disproportionately impacted communities like Black/African American, Hispanic/Latino, and American Indian/Alaska Native populations who face higher rates of kidney failure.1
The Role of Your Kidneys
Your kidneys are two bean-shaped organs that act as your body’s critical filtration system. They are essential for removing waste products and extra water from your blood, maintaining blood pressure, regulating important minerals, and helping to make red blood cells.2
What is Chronic Kidney Disease (CKD)?
Chronic kidney disease is a long-term condition where the kidneys are damaged and gradually lose their ability to function over time, typically for three months or more.2 This is a progressive condition, meaning the damage worsens slowly, often without noticeable symptoms until later stages.3 The most common risk factors for CKD are diabetes and high blood pressure.1
CKD is typically classified into five progressive stages (G1 to G5) based on the estimated Glomerular Filtration Rate (eGFR), which is a measure of how effectively the kidneys are filtering waste products from the blood:2,4
- Stage 1 (G1): Normal or high GFR (90 mL/min/1.73 m2 or greater), but with other evidence of kidney damage, such as protein in the urine (albuminuria).2,4
- Stage 2 (G2): Mildly decreased GFR (60–89 mL/min/1.73 m2) along with signs of kidney damage.2,4
- Stage 3a (G3a): Mildly to moderately decreased GFR (45–59 mL/min/1.73 m2).2,4 Waste products begin to build up, and symptoms like fatigue or swelling may start to appear.2
- Stage 3b (G3b): Moderately to severely decreased GFR (30–44 mL/min/1.73 m2).2,4 Symptoms are more likely to appear in this sub-stage, and complications are more common.2
- Stage 4 (G4): Severely decreased GFR (15–29 mL/min/1.73 m2).2,4 This is a critical stage that requires a person to have regular visits with a kidney specialist (nephrologist) to plan for future treatments, as it is the last stage before kidney failure.2
- Stage 5 (G5): Kidney Failure is reached when the GFR is less than 15 mL/min/1.73 m2 or the person is already undergoing dialysis.2,4
The primary goal in managing CKD at any stage is to slow its progression and prevent it from reaching the final stage.2
What is Kidney Failure?
Kidney failure, also referred to as renal failure, is a term used to describe a point where the kidneys have lost almost all their function and can no longer keep you alive without intervention.2,5 This is the final and most severe form of kidney disease.6
When kidney failure develops from the progression of CKD, it is classified as Stage 5 CKD and is often called End-Stage Renal Disease (ESRD) or End-Stage Kidney Disease (ESKD).2,7
- Stage 5 CKD/ESRD/ESKD: This occurs when the eGFR is less than 15 mL/min/1.73 m2 or when a person is already on dialysis.2 At this point, approximately 85% to 90% of kidney function is lost.2,7
The buildup of waste products and fluid makes a person very sick, and survival requires a treatment called renal replacement therapy, which includes dialysis (hemodialysis or peritoneal dialysis) or a kidney transplant.2,7
Key Differences Summarized
|
Feature
|
Chronic Kidney Disease (CKD)
|
Kidney Failure (Stage 5 CKD/ESRD)
|
|---|---|---|
|
Definition |
A long-term condition where the kidneys are damaged and gradually lose function over months or years.2 |
The final, most severe stage of CKD where kidney function is severely lost (85%–90%) and cannot sustain life without treatment.2,7 |
|
Progression/Stage |
A progressive disease encompassing Stages 1 through 5, with Stage 5 being the most advanced.2 |
Represents Stage 5 CKD and is also known as End-Stage Renal Disease (ESRD) or End-Stage Kidney Disease (ESKD).2,7 |
|
eGFR Level |
Varies by stage, from normal/high (Stage 1) down to severely decreased (Stage 4: 15–29 mL/min/1.73 m2).2 |
eGFR is less than 15 mL/min/1.73 m2 or the person is already on dialysis.2 |
|
Treatment Goal |
To slow the progression of kidney damage and keep the kidneys working as long as possible through managing underlying conditions like diabetes and high blood pressure.2 |
Required for survival: Renal replacement therapy, which is either dialysis (hemodialysis or peritoneal) or a kidney transplant.2,7 |
In simple terms, CKD is the long-term condition of deteriorating kidney function, and kidney failure is the point at which that deterioration reaches its end stage, requiring life-sustaining treatment.6
References
- National Kidney Foundation. Health Equity and Chronic Kidney Disease. [Internet]. Published 2024. Accessed October 5, 2025. Available from: https://www.kidney.org/kidney-topics/health-equity-and-chronic-kidney-disease
- National Kidney Foundation. Stages of Chronic Kidney Disease (CKD). [Internet]. Published 2024. Accessed October 5, 2025. Available from: https://www.kidney.org/kidney-topics/stages-chronic-kidney-disease-ckd
- Healthline. What’s the Difference Between Acute Renal Failure and Chronic Kidney Disease? [Internet]. Published 2024. Accessed October 5, 2025. Available from: https://www.healthline.com/health/kidney-disease/acute-renal-failure-vs-chronic-kidney-disease
- Vaidya SR, Aeddula NR. Chronic Kidney Disease. [Updated 2024 Jul 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535404/
- American Kidney Fund. Quick kidney disease facts and stats. [Internet]. Published 2024. Accessed October 5, 2025. Available from: https://www.kidneyfund.org/all-about-kidneys/quick-kidney-disease-facts-and-stats
- MedicalNewsToday. Renal failure vs. kidney failure: Are they the same? [Internet]. Published December 22, 2022. Accessed October 5, 2025. Available from: https://www.medicalnewstoday.com/articles/is-renal-failure-the-same-as-kidney-failure
- National Kidney Foundation. Chronic kidney disease (CKD) – Symptoms, causes, treatment. [Internet]. Published 2024. Accessed October 5, 2025. Available from: https://www.kidney.org/kidney-topics/chronic-kidney-disease-ckd
