VA Rating for Kidney Disease (The Ultimate Guide)

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Kidney disease is a silent threat—often undetected until it’s already causing serious damage.

And for many veterans, the cause can be traced back to military service: Agent Orange exposure, diabetes, high blood pressure, or other service-connected conditions.

If you’re a veteran suffering from kidney issues and you’re not getting VA disability compensation, you could be leaving thousands of dollars in monthly, tax-free benefits on the table.

In this Ultimate Guide, we’ll break down everything you need to know to qualify for a VA rating for kidney disease—plus the exact rating criteria and how to build a winning VA claim.

Let’s begin!

Summary of Key Points

• Kidney disease is a serious but often silent condition that affects many veterans—commonly caused by diabetes, high blood pressure, or exposure to toxic substances like Agent Orange. If left untreated or unrecognized, it can progress to kidney failure, requiring dialysis or a transplant.

• The VA rates kidney disease based on severity using Glomerular Filtration Rate (GFR) ranges, with disability ratings from 0% to 100%. A lower GFR indicates worse kidney function and can result in a higher VA disability rating.

• To qualify for VA disability benefits, veterans must show a current diagnosis, a service-connected event, and a medical nexus linking their kidney disease to military service. This includes both direct and secondary service connections, such as kidney disease secondary to service-connected diabetes.

• Filing a strong claim requires documented medical evidence, a completed VA Form 21-526EZ, and possibly attending a C&P exam. Submitting an Intent to File form can protect your effective date while you gather supporting evidence.

What is Chronic Kidney Disease?

Chronic kidney disease (CKD) occurs when the kidneys are damaged and can’t filter blood as they should. 

According to the National Kidney Foundation, an estimated 37 million in the United States may have chronic kidney disease, but only 90% know of their condition. 

Symptoms of Chronic Kidney Disease (CKD) 

• Nausea

• Fatigue

• Loss of appetite

• Vomiting 

• Difficulty sleeping

• Persistent itching

• Loss of appetite

• Chest pain

• High blood pressure

• Changes in urination

Unfortunately, chronic kidney disease can lead to end-stage kidney failure, so treating the condition at its first signs is essential. 

Generally, the only way to assist someone with end-stage kidney failure is through dialysis or a kidney transplant.

Three Types of Kidney Disease in Veterans 

#1. Acute Kidney Failure (Acute Kidney Injury)

• Definition: Acute Kidney Failure—also called Acute Kidney Injury (AKI)—occurs when your kidneys suddenly lose the ability to filter waste from your blood. This can happen in just a few hours or days and is often triggered by trauma, severe dehydration, infections, or exposure to toxic substances (including certain medications or chemicals).

• Veteran-Specific Example: A combat veteran who suffers severe dehydration and blood loss from an IED blast in Afghanistan could experience acute kidney failure due to sudden drop in blood flow to the kidneys.

• Key Signs: Sudden decrease in urine output, swelling, fatigue, confusion.

#2. Chronic Kidney Disease (CKD)

• Definition: Chronic Kidney Disease is a long-term, progressive loss of kidney function. It typically develops over months or years and is most often caused by diabetes, high blood pressure, or long-term exposure to harmful substances like Agent Orange.

• Veteran-Specific Example: A Vietnam veteran exposed to Agent Orange who later develops high blood pressure and diabetes may experience a gradual decline in kidney function over decades, ultimately being diagnosed with stage 3 or 4 CKD.

• Key Signs: Fatigue, swelling in legs or feet, frequent urination, high blood pressure, abnormal bloodwork (low GFR).

#3. Diabetic Nephropathy

• Definition: Diabetic Nephropathy is kidney damage caused specifically by long-standing, uncontrolled diabetes (type 1 or type 2). Over time, high blood sugar damages the blood vessels in the kidneys, reducing their filtering ability.

• Veteran-Specific Example: A Gulf War veteran with service-connected type 2 diabetes develops elevated levels of protein in their urine and a declining glomerular filtration rate (GFR), leading to a diagnosis of diabetic nephropathy as a secondary condition to diabetes.

• Key Signs: Protein in urine, swelling in lower limbs, worsening blood pressure control, elevated creatinine levels.

Causes and Risk Factors of Kidney Disease in Veterans

• 1. Diabetes Mellitus (Type 1 and Type 2): Chronic high blood sugar damages the kidneys’ filtering units, leading to diabetic nephropathy.

• 2. Hypertension (High Blood Pressure): Elevated blood pressure strains blood vessels in the kidneys, impairing their filtering ability over time.

• 3. Exposure to Agent Orange: While not a presumptive condition, Agent Orange exposure is linked to diabetes and hypertension, both of which can lead to kidney disease.

• 4. Glomerulonephritis: An inflammation of the kidney’s filtering units, often resulting from infections or autoimmune diseases, leading to impaired kidney function.

• 5. Rhabdomyolysis: A condition where damaged muscle tissue releases harmful proteins into the bloodstream, potentially causing acute kidney injury. This can result from severe physical exertion, trauma, or certain medications.

• 6. Nephrotoxic Medications: Long-term use of certain drugs, such as NSAIDs, some antibiotics, and chemotherapy agents, can damage kidney tissue.

• 7. Urinary Tract Obstruction: Blockages from kidney stones, enlarged prostate, or tumors can impede urine flow, leading to kidney damage.

• 8. Autoimmune Diseases: Conditions like lupus or rheumatoid arthritis can cause inflammation in the kidneys, leading to chronic kidney disease.

• 9. Infections: Repeated or severe kidney infections can cause scarring and long-term kidney dysfunction.

• 10. Obesity: Excess body weight increases the risk of developing conditions like diabetes and hypertension, which are primary contributors to kidney disease.

• 11. Smoking: Tobacco use can impair blood flow to the kidneys and exacerbate existing kidney conditions.

• 12. Age and Family History: Advancing age and a family history of kidney disease can increase susceptibility to kidney dysfunction.

How the VA Rates Kidney Disease 

You can find the kidney disease VA rating under 38 CFR § 4.115a, Ratings of the Genitourinary System – Dysfunctions, with kidney disease following the criteria for renal dysfunction. 

Kidney Disease VA Disability Ratings

A VA disability rating for Kidney Disease can be 0%, 30%, 60%, 80%, or 100%.

• 100% VA Rating Criteria – Chronic kidney disease with glomerular filtration rate (GFR) less than 15 mL/min/1.73 m 2 for at least 3 consecutive months during the past 12 months; or requiring regular routine dialysis; or eligible kidney transplant recipient

• 80% VA Rating Criteria – Chronic kidney disease with GFR from 15 to 29 mL/min/1.73 m 2 for at least 3 consecutive months during the past 12 months

• 60% VA Rating Criteria – Chronic kidney disease with GFR from 30 to 44 mL/min/1.73 m 2 for at least 3 consecutive months during the past 12 months

• 30% VA Rating Criteria – Chronic kidney disease with GFR from 45 to 59 mL/min/1.73 m 2 for at least 3 consecutive months during the past 12 months

• 0% VA Rating Criteria – GFR from 60 to 89 mL/min/1.73 m2 and either recurrent red blood cell (RBC) casts, white blood cell (WBC) casts, or granular casts for at least 3 consecutive months during the past 12 months; OR GFR from 60 to 89 mL/min/1.73 m 2 and structural kidney abnormalities (cystic, obstructive, or glomerular) for at least 3 consecutive months during the past 12 months; OR GFR from 60 to 89 mL/min/1.73 m 2 and albumin/creatinine ratio (ACR) ≥30 mg/g for at least 3 consecutive months during the past 12 months

Important Notes

• GFR (Glomerular Filtration Rate) is a critical measure used to evaluate how well your kidneys are functioning. It estimates how much blood your kidneys filter each minute and is reported in milliliters per minute per 1.73 square meters of body surface area (mL/min/1.73 m²).

• GFR shows how well your kidneys are filtering your blood. 

Guidelines for GFR

• A GFR of 60 or higher is considered normal

• A GFR below 60 could mean kidney disease

• A GFR of 15 or below could mean kidney failure

GFR Ranges and Kidney Disease Stages:

GFR Range	Stage	Kidney Function
90+	Stage 1	Normal function but with kidney damage
60–89	Stage 2	Mild loss of kidney function
45–59	Stage 3A	Mild to moderate loss
30–44	Stage 3B	Moderate to severe loss
15–29	Stage 4	Severe kidney function loss
<15 or on dialysis	Stage 5 (End-Stage Renal Disease)	Kidney failure

How to Qualify for a VA Rating for Kidney Disease 

To qualify for VA disability for kidney disease, you must provide evidence of the following:

• A current diagnosis 

• An in-service event, injury, or illness

• A medical nexus (i.e., link) between the current diagnosis and the in-service event, injury, or illness 

Steps to Submit a Disability Claim for Kidney Disease 

• Gather your evidence and supporting documents (i.e., VA medical records, hospital records, private medical records, hospital reports, and supporting statements)

• Submit your VA Form 21-526EZ claim online, in person at your local regional VA office, or by mail to:

Pro Tip: If you plan on applying for VA disability for kidney disease using a paper form, you should submit an intent to file form, which gives you time to gather the necessary evidence and documentation and sets your back pay date.

Secondary Service Connection for Kidney Disease

Diabetes is the most common secondary condition to kidney disease, with type 2 diabetes being the leading cause of kidney disease. 

If your service-connected diabetes causes kidney disease, you may be eligible for a secondary service connection. 

A secondary service-connected disease arises because of a previously service-connected disability. 

VA C&P Exam for Kidney Disease 

You’ll likely be required to attend a VA Compensation & Pension (C&P) exam for kidney disease as part of the disability claims process.

The purpose of the C&P exam is to evaluate the severity of your kidney condition and assess whether it’s related to your military service.

The examiner will review your medical history, ask about symptoms, and may order or review lab results such as your glomerular filtration rate (GFR).

If the VA determines a C&P exam is needed, you’ll be contacted to schedule the appointment after your claim is submitted.

Be sure to attend, as missing the exam can result in a denial or delay of your claim.

Conclusion & Wrap-Up

Kidney disease is one of the most dangerous “silent” conditions affecting veterans—often progressing without obvious symptoms until serious damage has already occurred.

Whether it’s acute kidney failure, chronic kidney disease, or diabetic nephropathy, many cases can be directly linked to service-connected conditions like diabetes, hypertension, or toxic exposures such as Agent Orange.

The good news?

You don’t have to fight this battle alone.

If you’re a veteran experiencing kidney issues, and you haven’t yet filed for VA disability—or you’ve been underrated or denied—you may be missing out on significant monthly, tax-free compensation.

And if your kidney disease was caused or aggravated by another service-connected condition, you may be eligible for a secondary service connection, which opens the door to increased benefits.

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