If the VA already service-connected your chronic kidney disease (also called kidney disease, CKD, nephropathy, renal insufficiency), it can cause or worsen other conditions that are ratable on their own. These "secondary" claims are where many veterans leave money on the table. Below is what a service-connected chronic kidney disease commonly leads to, why, and what evidence each one takes.
Kidney disease is rated on the renal dysfunction scale in 38 CFR 4.115a, mostly by your GFR (glomerular filtration rate) from lab work. Estimated GFR counts when calculated by a medical professional.
| Renal dysfunction (38 CFR 4.115a) | Rating |
|---|---|
| CKD with GFR under 15, or regular routine dialysis, or eligible kidney transplant recipient | 100% |
| CKD with GFR 15 to 29 | 80% |
| CKD with GFR 30 to 44 | 60% |
| CKD with GFR 45 to 59 | 30% |
| GFR 60 to 89 plus casts, structural kidney abnormality, or albumin/creatinine ratio of 30 mg/g or more | 0% |
Each GFR level must be present for at least 3 consecutive months during the past 12 months. GFR is in mL/min/1.73 m².
A secondary claim only works if the primary condition (chronic kidney disease) is already service-connected, and you have a nexus — a doctor's opinion that it is "at least as likely as not" the cause. Nexus letter sample and template →
Kidney disease and high blood pressure drive each other; VA recognizes hypertension caused or aggravated by renal disease as secondary.
What you'd need: Blood-pressure readings (multiple, over time), labs (creatinine/GFR), and a nexus opinion linking the hypertension to the kidney disease.
Damaged kidneys make less erythropoietin, so chronic kidney disease commonly causes anemia — a distinct, ratable condition.
What you'd need: A complete blood count showing anemia and a nexus opinion tying it to the kidney disease.
Chronic kidney disease impairs the vascular and hormonal pathways behind erections. ED is usually 0% but opens tax-free SMC-K.
What you'd need: An ED diagnosis and a nexus opinion linking it to the renal disease.