 I am Dr. Vishwanath, consultant nephrologist and HOD in nephrology. I am working at Manipal Hospital, Bangalore. Chronic kidney disease is a staged, what we call as stages of various kidney chronic kidney disease. There are five stages, one starts with early stage and five starts with goes to very low kidney function. Stage one is where you have, though you have relatively good kidney function you may find some protein in the urine, you may find some blood in the urine, you may find some cysts in the urine where we classify them as stage one. This is where something which we can do to prevent further progression. As the stages go beyond 1, 2, 3, 4 and 5, 5 is a stage where more than 90% of kidney is damaged, what we call in medical terms as GFR. When GFR comes to less than 15 ml then it is classified as stage 5 where definitely medical management alone will not be sufficient. We need to consider doing either dialysis or kidney transplantation to replace the kidney.