A person with stage 3 chronic kidney disease (CKD) has moderate kidney damage. This stage is broken up into two: a decrease in glomerular filtration rate (GFR) for Stage 3A is 45-59 mL/min and a decrease in GFR for Stage 3B is 30-44 mL/min. As kidney function declines waste products can build up in the blood causing a condition known as “uremia.” In stage 3 a person is more likely to develop complications of kidney disease such as high blood pressure, anemia (a shortage of red blood cells) and/or early bone disease.
Symptoms may start to become present in stage 3, such as:
As stage 3 progresses, the NKF recommends the patient see a nephrologist (a doctor who specializes in treating kidney disease). Nephrologists examine kidney patients and perform lab tests so they can gather information about their condition to offer the best advice for treatment. The nephrologist’s goal is to help their patient keep their kidneys working as long as possible.
Someone in stage 3 may also be referred to a dietitian. Because diet is such an important part of treatment, the dietitian will review a person’s lab work results and recommend a meal plan individualized for their needs. Eating a proper diet can help preserve kidney function and overall health. For stage 3 a dietitian will usually recommend eating a healthy diet with protein at the Daily Reference Intake (DRI) level of 0.8 grams protein per kilogram body, the same level recommended for all healthy people. Special attention may be given to the quality of protein eaten. Phosphorus may be limited to help keep blood phosphorus or PTH normal and prevent renal bone disease. Controlling phosphorus may also help preserve existing kidney function. Calcium may be limited if blood levels are too high. Potassium is usually not restricted in stage 3 CKD unless blood levels are high. The dietitian will also take into consideration if the patient has diabetes and provide tips on limiting carbohydrates in their diet. They may also recommend a diet low in sodium for those with high blood pressure or fluid retention. Supplementation with water soluble vitamins may be recommended. Vitamin C may be limited to 100 mg per day from supplements. Nutrients like Vitamin A and some minerals may not be recommended because levels can build up in the blood as kidney function declines. The dietitian may recommend avoiding over the counter dietary supplements unless approved by the nephrologist. It is helpful to work with a registered renal dietitian because as the stages of CKD change, so will the diet.
A healthy diet for stage 3 CKD may recommend:
Many people who develop CKD have diabetes or high blood pressure. By keeping their glucose level under control and maintaining a healthy blood pressure, this can help them preserve their kidney function. For both of these conditions, a doctor will likely prescribe a blood pressure medicine. Studies have shown that ACE (angiotensin converting enzyme) inhibitors and ARBs (angiotensin receptor blockers) help slow the progression of kidney disease even in people with diabetes who do not have high blood pressure.Patients should ask their doctors about all of their medicines and take them exactly as prescribed.
In addition to eating right and taking prescribed medicines, exercising regularly and not smoking are helpful to prolonging kidney health. Patients should talk to their doctors about an exercise plan. Doctors can also provide tips on how to stop smoking.
People in Stage 3 CKD will usually visit their doctor every 3-6 months. Blood tests for creatinine, hemoglobin, calcium and phosphorus levels will be performed to see how well the kidneys are functioning. The doctor will also monitor other conditions such as high blood pressure and diabetes.
There is no cure for kidney disease, but it may be possible to stop its progress or at least slow down the damage. In many cases, the correct treatment and lifestyle changes can help keep a person and their kidneys healthier longer.
If you would like to see a doctor who specializes in the care of kidneys, called a nephrologist, you can use DaVita's Find a Kidney Doctor tool to locate a nephrologist in your area.
This site is for informational purposes only and is not intended to be a substitute for medical advice from a physician.
Please check with a physician if you need a diagnosis and/or for treatments as well as information regarding your specific condition. If you are experiencing urgent medical conditions, call 9-1-1