What Is Stage 3 CKD?

For someone with stage 3 chronic kidney disease (CKD), this means there is moderate kidney damage. While stage 1 and stage 2 are generally asymptomatic, physical symptoms start to present themselves in stage 3. If you or someone you love has stage 3 CKD, it’s important to understand potential symptoms, what doctors to talk to, and how to manage disease progression moving forward.

What does stage 3 kidney disease mean?

At stage 3 CKD, your eGFR is between 30 and 59, which is a sign that your kidneys have some damage and are not working as well as they should be. Moreover, this stage of kidney disease is split into two by glomerular filtration rate (GFR):

  • Stage 3A: You have a GFR of 45-59 mL/min.
  • Stage 3B: You have a GFR of 30-44 mL/min.

When your kidney function declines, your kidneys are less able to filter waste products out of the blood. This can cause a build-up, called uremia. In stage 3 CKD, you also become more likely to have related complications, including:

To diagnose CKD stage 3, your doctor will perform the following tests:

  • eGFR tests (which will be repeated every 90 days from initial diagnosis)
  • Blood pressure readings
  • Urine tests
  • Imaging tests (to rule out a more advanced stage of CKD)

What are the symptoms of stage 3 kidney disease?

As previously mentioned, the first two stages of CKD are largely asymptomatic. Kidney disease symptoms typically start to appear in stage 3 CKD.

Black man from behind with hands on back in pain

Back pain, specifically in your lower back, can be an indication of kidney disease.
(This image is by @rawpixel.com for Freepik.)

Potential symptoms of stage 3 kidney disease include:

  • Unexplained fatigue
  • Fluid retention
  • Swelling (edema) of extremities
  • Shortness of breath
  • Changes in urination (foamy; dark orange, brown, tea-colored, or red if bloody; and urinating less or more than normal)
  • Back pain, specifically lower back
  • Trouble sleeping, due to restless legs or muscle cramps.

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Is Stage 3 kidney disease serious? How can it be managed?

While stage 3 kidney disease indicates a decline in kidney function, there are still many treatment options available to manage the disease and symptoms, as well as slow disease progression.

From a lifestyle standpoint, you should:

  • Control your blood sugar if you have diabetes.
  • Do not smoke or use tobacco, and quit if you do.
  • Manage your blood pressure.
  • Eat healthily, and follow a kidney-friendly diet.
  • Maintain a healthy weight.
  • Get 30 minutes of physical activity five days a week.
Older couple exercising outside

Regular exercise is one of the important lifestyle changes you can make to slow disease progression.
(This image is from Freepik.)

Additionally, it’s time to make an appointment with a nephrologist (kidney doctor) if you haven’t done so already. They will develop a treatment plan that fits your unique situation, including regular kidney check-ups.

If making dietary changes feels overwhelming or you feel like you don’t know where to start, you should meet with a renal dietitian. Diet is crucial to the successful treatment of kidney disease, as it can preserve kidney function and improve your overall health. Your renal dietitian will create a specialized meal plan for you to follow.

What treatments are available?

At stage 3, you do not yet need dialysis or a kidney transplant. Lifestyle changes play a large role in CKD treatment, but certain medications may also be prescribed. It’s common for people with CKD to develop diabetes or high blood pressure as a result. To control your glucose level and maintain healthy blood pressure, your doctor will probably prescribe a blood pressure medicine.

The two most frequently prescribed blood pressure medications are:

Research has shown that both of these medications help to slow kidney disease progression—“even in people with diabetes who do not have high blood pressure,” according to DaVita Kidney Care.

Other treatments that may be prescribed to help with the symptoms and side effects of CKD include:

  • Calcium and/or vitamin D supplements to prevent bone fractures
  • Chlorestol-lowering drugs
  • Diuretics to treat edema
  • Iron supplements for anemia