Chronic kidney disease (CKD) progression is divided into five stages. These stages indicate the extent of kidney function loss. Stage 3 is a pivotal stage in CKD progression, and is often when noticeable symptoms appear. Learn more about stage 3 CKD, including what symptoms to look for, and how to prevent further kidney damage and function decline. 

How is a CKD stage determined?

Your CKD stage is based on your estimated glomerular filtration rate (eGFR) results, which are determined by a blood test. This test tells your doctor how well your kidneys are working, with a higher eGFR indicating better kidney function. Each CKD stage is associated with an eGFR result. The numbers represent the percentage of kidney function that you still have. 

• Stage 1: eGFR is 90 or higher (no symptoms)
• Stage 2: eGFR is 60-89 
• Stage 3a: eGFR is 45-59 (symptoms begin)
• Stage 3b: eGFR is 30-44 
• Stage 4: eGFR is 15-29 
• Stage 5: eGFR is less than 15 (kidney failure)

The earlier CKD is identified, the easier it is to prevent, or at least slow, progression. 

What occurs at stage 3 CKD?

Considered the middle stage, stage 3 CKD shows there is mild to moderate kidney damage. This damage can cause other complications such as high blood pressure, anemia (not enough red blood cells), and a decline in bone health. You may start to notice symptoms such as:

• Swelling in your hands and feet
• Weakness and/or fatigue
• Dry or itchy skin
• Pain in your lower back
• Muscle cramps
• Changes in your urine, such as the appearance of bubbles or froth

Fortunately, many patients at this stage are able to address symptoms and slow the progression of the disease with a combination of medical treatment and healthy lifestyle adjustments. 

How do I slow or stop CKD progression?

CKD cannot be fully reversed, but there are things to be done to prevent further damage. Following a treatment plan may not only help with CKD, but can also prevent associated complications from CKD, such as heart disease. Treatment can include diuretics, beta blockers and statins to lower blood pressure and cholesterol, and vitamins or other supplements.

Some lifestyle tips to help slow the progression include:

• Follow a heart-healthy diet, which include lean protein sources, low sodium/salt, and plenty of fresh fruits and vegetables
• Aim for a healthy weight for your particular frame
• Start or maintain regular physical activity regimen
• Get enough good quality sleep
• Quit smoking
• Manage stress in healthy, productive ways such as meditation and journaling

What questions should I ask my doctor? 

If you are in stage 3 CKD, you may be wondering what you should discuss with your doctor at this point. Here are a few questions to raise. 

• Are my current treatments for underlying medical conditions sufficient to prevent or slow further kidney function loss? Dangerous underlying conditions include diabetes, anemia, high blood pressure, heart failure, autoimmune kidney disease, hepatitis C, and HIV (human immunodeficiency virus).
• What over-the-counter medications should I avoid? Certain drugs and medications can hurt kidney function, including nonsteroidal anti-inflammatory drugs (NSAIDs, such as Advil/ibuprofen and Aleve/naproxen).
• Is there any specific medication I can take to slow CKD progression? In addition to the medications mentioned above, drugs that can help slow CKD progress include ACE (angiotensin-converting enzyme) inhibitors and SGLT2 (sodium-glucose cotransporter 2) inhibitors.

If you do not have a nephrologist (kidney doctor) at stage 3 CKD, talk to your primary care doctor about getting a referral. Nephrologists specialize in all things kidney-related, and can ensure that your CKD is optimally managed. 

*Martin, C. (2022, May 3). Living With Stage 3 Chronic Kidney Disease. Verywell Health. https://www.verywellhealth.com/stage-3-chronic-kidney-disease-5223122