CKD develops through stages 1–5. If a person has stage 3 CKD, they may begin to experience more noticeable symptoms, such as fatigue, swelling, and difficulty sleeping.
At stage 3 chronic kidney disease (CKD), kidney damage is mild to moderate. Many people start to have symptoms at this stage, but some may not.
Even though kidney damage is not reversible once CKD reaches stage 3, the kidneys can still function independently. A person living with the condition can also take steps to prevent CKD from reaching stages 4 and 5.
This article explores the symptoms, causes, diagnosis, treatment, and outlook of stage 3 CKD. It also discusses when to reach out to a healthcare professional.
- weakness and fatigue
- dry, itchy skin
- edema, or swelling in the hands and feet
- changes in how often a person urinates
- lower back pain
- difficulty sleeping
- muscle cramps
- restless legs syndrome
- passing urine that appears darker or foamier than usual
- heart and blood vessel issues
- slow bone growth
- bone deformities
- a higher risk of fractures
However, even at stage 3, CKD may not cause symptoms in some people.
Stage 3 CKD develops after kidney damage worsens during stages 1 and 2. This could occur due to
- the gradual loss of functional tissue in the kidneys
- ongoing inflammation that does not get better
- a reduced ability for the kidneys to recover from damage
Diabetes develops when the body cannot control blood glucose levels as effectively as usual due to a shortage of insulin. Insulin is a hormone that helps cells take in glucose. Glucose is a type of sugar in the blood.
If the cells cannot use enough glucose, this increases blood glucose levels over time. Consistently high blood glucose can damage the kidneys’ filters, called nephrons, that remove waste.
High blood pressure
High blood pressure is the
Rarer causes of kidney disease include:
- polycystic kidney disease (PKD)
- diseases that affect the whole body, such as lupus
- exposure to heavy metals, such as lead
- prolonged or recurring kidney infections
- chronic obstructions
- toxic reactions to drugs
- hemolytic uremic syndrome
- autoimmune disorders, such as Goodpasture disease
- rare genetic disorders, such as Alport syndrome
immunoglobulin A (IgA) vasculitis, which describes a buildup of an antibody called IgA in blood vessels IgA nephropathy, which refers to a buildup of IgA in the kidneys renal artery stenosis, which describes narrowing of the arteries in the kidneys
People with stage 2 CKD are at risk of developing stage 3 CKD. However, regular monitoring, management, and treatment at stage 2 can help reduce the progression to stage 3.
The following groups of people are more likely to develop CKD:
- people with diabetes
- people with high blood pressure
- people with a family history of kidney disease
- older adults
- African Americans, Hispanic Americans, Asian Americans, Pacific Islanders, and Native Americans
During stage 3, CKD may have started causing noticeable symptoms.
Doctors will ask about these symptoms and try to rule out various underlying health problems and possible causes. However, in people who are not yet having symptoms, a doctor
- heart disease
- high blood pressure
- a family history of kidney disease
A doctor can run various tests to measure how the kidneys work and to look for signs of CKD.
Estimated glomerular filtration rate test
An estimated glomerular filtration rate (eGFR) test can show the current stage of CKD.
This blood test estimates kidney function by measuring levels of a waste product called creatinine. Healthy kidneys eliminate creatinine in the urine, but this waste product builds up if the kidneys are damaged.
An eGFR number can help demonstrate how healthy or damaged the kidneys are. Doctors divide stage 3 CKD eGFR numbers into two categories:
- 3A: 45–59 eGFR range
- 3B: 30–44 eGFR range
A lower eGFR number indicates a greater loss of kidney function. Therefore, if a person has stage 3B CKD, their kidneys are likely to be more damaged than someone living with stage 3A CKD.
A doctor might order other tests to measure kidney damage and identify causes, including:
- blood pressure tests
- urine tests to assess how the kidneys are working and confirm the CKD stage, as well as to monitor health issues like diabetes, urinary tract infections (UTIs), and other infections that could be affecting the kidneys
- imaging scans to check the physical structure of the kidneys, including ultrasound, MRI, and CT scans
- a biopsy, in which a doctor analyzes a tissue sample from the kidney under a microscope
The goals of stage 3 CKD treatment include:
- addressing any symptoms
- managing any underlying conditions
- preventing progression to stage 4 or 5 CKD
Preventing and slowing the progression of CKD often depends on managing blood pressure.
High blood pressure is both a cause and complication of CKD, as the kidneys control blood pressure. This makes blood pressure management vital for maintaining kidney function at stage 3.
A doctor may suggest a blood pressure target for each person to reduce the risk of CKD worsening. Keeping blood pressure in range might involve:
- eating foods good for the heart and low in sodium
- exercising regularly, ideally with at least
150 minutesof moderate intensity physical activity per week
- getting at least
7 hoursof sleep every night
Manage blood sugar
Managing blood sugar levels can help reduce the effects of diabetes on the kidneys. This involves:
- regular blood sugar monitoring
- eating foods that do not spike blood sugar
- getting regular exercise
- taking any medications as instructed by a doctor
A doctor may measure long-term glucose levels using an A1C test. This test shows blood sugar levels over 3 months.
Staying below A1C targets, usually
Address other CKD symptoms
It is also important to manage the increasing negative effects of stage 3 CKD on bone health, fluid retention, and nutritional deficiencies.
To manage these effects, a doctor may prescribe:
- supplements for calcium and vitamin D
- iron, vitamin B12, or folate supplements if there is a deficiency
CKD monitoring and avoiding medication side effects
Regular consultations with a doctor are important for managing stage 3 CKD. A person and their doctor can compare eGFR and urine test results with the previous consultation to ensure kidney function is not worsening.
People with kidney damage also need to avoid medications that can worsen it. These include common over-the-counter nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil), that people may take for headaches and mild pain.
A person can speak with a healthcare professional before taking any medications.
It is not typically possible to recover from kidney damage. A person with stage 3 CKD cannot usually reverse damage to earlier stages.
However, as long as a person makes healthcare choices that reduce the risk of progression, they can preserve kidney function.
Preventing progression to late stage kidney disease is central to maintaining quality of life for people with stage 3 CKD.
People living with earlier stages of CKD, diabetes, heart disease, or high blood pressure should regularly meet with a doctor or qualified healthcare professional to check for disease progression and complications.
A person can also consult a qualified healthcare professional if they notice any symptoms of stage 3 CKD.
Stage 3 CKD is the midpoint on the CKD spectrum. It means a person’s kidneys have experienced mild to moderate kidney damage.
Stage 3 CKD causes noticeable symptoms in most cases. CKD often occurs due to diabetes or high blood pressure.
Managing symptoms, such as edema and anemia, and other conditions, such as high blood pressure and diabetes, can help people with stage 3 CKD prevent progression to the later stages of CKD and maintain a good quality of life.
A person can speak with a qualified healthcare professional for further information and advice about stage 3 CKD.