What is Stage 3 CKD?
Stage 3 CKD occurs when your eGFR is between 30 – 59, indicating moderate kidney damage.
At this stage, kidney function declines gradually over time and can possibly lead to kidney failure in some patients. This damage is not reversible but there are many actions that can be taken to slow or stop further kidney damage.
An overview of stage 3 chronic kidney disease (CKD)
Chronic kidney disease (CKD) is divided into 5 stages based on kidney function, and whether there are signs of blood or protein in the urine.
At CKD stage 3, your kidneys have been moderately damaged. Therefore, they are not filtering salts and toxins optimally and maintaining fluid balance may be a problem.
Based on the level of kidney function, this stage is further split into two sub-stages: CKD Stage 3a where eGFR is between 45 - 59 and CKD Stage 3b where eGFR is between 30 - 44, The stage you are in may result in some variations in the treatment approach.
At stage 3 CKD, your doctor will closely monitor you to see if there is protein in the urine, as higher amounts of protein can mean more risk of CKD progression and an increased need for treatments.
Signs & Symptoms of stage 3 chronic kidney disease (CKD)
Stage 3 CKD is the stage when patients typically start to experience the first signs and symptoms of kidney disease, due to the buildup of toxins and fluids in the body caused by the decline in kidney function.
The symptoms of stage 3 CKD may include:
- Fatigue
- Swelling in your hands and feet
- Change in urine colour or volume
- Muscle cramps
- Itch
- Poor appetite
These symptoms may not occur at all or at the same time and may appear only gradually as your chronic kidney disease (CKD) progresses. Learn more about the different kidney disease symptoms you may experience and why.
Causes of stage 3 chronic kidney disease (CKD)
Chronic kidney disease (CKD) is often caused by other pre-existing health conditions. Some common causes of CKD are hypertension (high blood pressure) and diabetes.
There are also factors that increase your risk of developing kidney disease or accelerating your CKD progression. Some common CKD risk factors are obesity and smoking.
Learn more about CKD causes and risk factors to manage your stage 3 CKD better.
Diagnosis at stage 5 chronic kidney disease (CKD)
Patients usually find out that they have chronic kidney disease when they are in stage 3 as that is when they first develop symptoms of kidney disease.
Treatment for stage 3 chronic kidney disease (CKD)
Stage 3 CKD cannot be cured. Treatment for stage 3 CKD is aimed at slowing down the rate of kidney disease progression and managing the health issues caused by declining kidney function.
Stage 3 CKD treatment includes medications such as Angiotensin-converting enzyme (ACE) inhibitors, Angiotensin-receptor blockers (ARBs) and sodium-glucose cotransporter-2 (SGLT-2) inhibitors which are effective at reducing further kidney damage and slowing down the progression of CKD.
Other treatments and changes in diet may also be required for possible health issues that may arise due to CKD, such as anaemia or high salt levels. However, there is no requirement for dialysis during stage 3 CKD.
During stage 3 CKD, your doctor will also be performing blood and urine tests regularly to gauge your CKD stage and its risk of progression.
Managing stage 3 chronic kidney disease (CKD)
Once diagnosed with CKD stage 3, it is important that you make some lifestyle changes and work with your doctor to optimally manage your condition. At this stage, your regular doctor is likely to refer you to a kidney specialist, also known as a nephrologist, to oversee your care in the long run.
Depending on your overall health, the required lifestyle changes can differ, but typically these will include specific changes to your diet, moderate exercises, quitting smoking and limiting alcohol consumption, maintaining a healthy weight, monitoring your general condition, and any other recommendations that your healthcare team may have for you.
Diet is an integral part of managing stage 3 CKD. Since kidneys are responsible for filtering out toxins and excess fluid from your body, what you consume impacts how much your kidneys need to work. When your kidneys are damaged, you may need to change your diet.
For stage 3 CKD, nutritional requirements vary between individuals. It is important to gain advice from a dietitian who can help create akidney-friendly diet planthat fits your specific needs.
Generally, a healthy diet for stage 3 CKD patient will involve:
- Increasing high quality protein intake
- Reducing daily sodium intake, calcium consumption and carbohydrates
- Limitingphosphorus, calcium, and potassium intake
- Maintaining water intake of about 1 liter per day
Exerciseis key to remaining healthy, and it is no different once you are diagnosed with chronic kidney disease (CKD). Regular exercise can also help manage other conditions, such as high blood pressure and diabetes. At stage 3 CKD, you will be able to exercise normally as before and even start a new exercise routine. You should discuss your exercise routine with your healthcare team and follow the recommendations.
Monitoring your health is vital at this stage. Your primary care doctor will typically help manage your overall health and monitor conditions such as high blood pressure and diabetes. On the other hand, your nephrologist will see you at regular intervals to assess the progression of your kidney disease.
The prognosis for stage 3 chronic kidney disease
At CKD stage 3, your kidneys are moderately damaged, and kidney function has declined. Treatments can effectively slow the progression of CKD and manage other health issues.
Stage 3 is still far from kidney failure, and a diagnosis at this stage can help improve the disease progression as treatment can commence, and the progression will be monitored carefully. It is possible to stay on CKD stage 3 for years with your kidney disease not progressing to end-stage kidney disease.
Stage 3 kidney disease life expectancy
Early diagnosis and management of stage 3 CKD can improve life expectancy. While some patients with stage 3 CKD may eventually progress to kidney failure, many people with kidney disease diagnosed in the early stages never do. With treatments such as kidney transplants or dialysis, patients with kidney failure can live for more than 10 years or even decades.
FREQUENTLY ASKED QUESTIONS
Stage 3 CKD cannot be cured or reversed, but its progression can be slowed with treatments such as ACE inhibitors, ARBS and now SGLT2 inhibitors. Often, patients with stage 3 CKD do not progress further and do not require dialysis.
The diagnosis of CKD can be achieved via a blood test to establish the level of kidney function. A standard test to diagnose the stage of CKD is a blood test that determines the estimated glomerular filtration rate (eGFR), which gives an indication of your kidney function. In stage 3 CKD, the eGFR is between 30 and 59 ml/min.
Your regular doctor can treat you in the beginning, but as your kidney disease progresses, you will need to be seen by a doctor who specialises in kidney health, also known as a nephrologist. It is very important that you regularly attend an outpatient clinic to be monitored for any progression of CKD and to ensure you receive the right treatments.
Early diagnosis and management of stage 3 CKD can improve life expectancy. Stage 3 CKD patients can expect to live for decades with drug treatment to delay or halt the progress of the disease.
Sharing your diagnosis with family and friends can be beneficial. To manage your CKD and slow its progression, you will have to make certain lifestyle changes, and it can be helpful if people around you understand your condition.
Even though CKD progresses from stage 3 to stage 4, the progression does not happen to everyone. The progression of kidney disease depends on multiple factors, including your overall health and how your kidneys respond to treatments and lifestyle changes. It is possible to remain in CKD stage 3 for a long period of time.
It can be overwhelming when you are first diagnosed with CKD. Talk to your doctor about your concerns. Some questions you may want to ask are:
- What is my eGFR? This will help you understand whether you are at CKD stage 3a or 3b.
- What should I expect next?
- What drugs may reduce kidney damage and slow the progression of CKD?
- What lifestyle changes do I need to make to slow down the progression of my kidney disease?
- Do I need a dietitian? Often your doctor can refer you to a renal dietitian who will help you follow a kidney-friendly diet plan.
Find out important questions to ask when meeting your kidney doctor or nephrologist to make an informed decision about your kidney disease treatment.
