Chronic Kidney Disease Stage 3: Symptoms, Causes, and Management

Chronic kidney disease (CKD) is a long-term condition where the kidneys gradually lose their ability to function properly. Among the five stages of CKD, Stage 3 is considered a moderate form of the disease and is a critical point for early intervention. In this stage, kidney damage is more noticeable, but there’s still a chance to manage symptoms and slow progression. This article explores chronic kidney disease Stage 3 in detail — including its symptoms, causes, risks, diagnosis, and management.

What is Chronic Kidney Disease Stage 3?

Chronic kidney disease is categorized into five stages based on the glomerular filtration rate (GFR), which measures how well the kidneys are filtering blood. Stage 3 means that a person’s GFR is between 30 to 59 mL/min, indicating moderate kidney damage.

Stage 3 is further divided into:

Stage 3a: GFR 45–59 mL/min
Stage 3b: GFR 30–44 mL/min

At this stage, waste products begin to build up in the blood, potentially leading to complications such as high blood pressure, anemia, and bone problems.

Common Symptoms of CKD Stage 3

Chronic kidney disease Stage 3 often doesn’t cause severe symptoms, but some people may begin to notice the following:

Fatigue or feeling weak
Swelling in hands or feet (edema)
Changes in urination (frequency, color, or volume)
Muscle cramps
Dry, itchy skin
Sleep problems
Back pain (near the kidney area)
Loss of appetite
Bad taste in the mouth or metallic taste

These symptoms can often be subtle, which is why regular medical check-ups are vital if you’re at risk.

Causes of Chronic Kidney Disease

Several underlying health conditions can lead to chronic kidney disease Stage 3:

Diabetes – The leading cause of CKD; high blood sugar levels damage kidney filters.
High blood pressure (Hypertension) – Puts extra pressure on kidneys, damaging nephrons over time.
Glomerulonephritis – Inflammation of the kidney’s filtering units.
Polycystic kidney disease – A genetic disorder that causes cysts in the kidneys.
Prolonged use of NSAIDs or painkillers – Can harm kidney tissues.
Autoimmune diseases – Like lupus, which can attack kidney tissues.

Often, CKD develops slowly over years due to these chronic conditions.

Risk Factors

Anyone can develop CKD, but certain factors increase the risk:

Age over 60
Family history of kidney disease
Ethnic background (higher prevalence in African, South Asian, or Indigenous populations)
Obesity
Smoking
Uncontrolled diabetes or hypertension
History of frequent kidney infections or urinary tract issues

Diagnosis of CKD Stage 3

Diagnosis typically involves:

Blood tests: To check creatinine and calculate GFR.
Urine tests: To detect protein or blood in the urine.
Imaging: Ultrasounds or CT scans to view kidney structure.
Blood pressure monitoring

Doctors may monitor the progression with repeated tests over time.

Complications of Stage 3 CKD

Without proper management, Stage 3 CKD can lead to:

High blood pressure that becomes harder to control
Anemia (low red blood cell count)
Bone disease due to imbalance of calcium and phosphate
Cardiovascular disease – Increased risk of heart attack or stroke
Electrolyte imbalances
Progression to Stage 4 or 5 CKD, where dialysis may become necessary

Can Stage 3 CKD Be Reversed?

While chronic kidney disease is usually irreversible, it can be managed effectively. The goal is to slow down the progression and reduce complications. Lifestyle changes and medication can have a significant impact.

Treatment and Management of CKD Stage 3

There is no cure for CKD, but treatment focuses on protecting kidney function and overall health:

1. Managing Underlying Conditions

Control blood sugar if diabetic
Lower blood pressure with ACE inhibitors or ARBs
Monitor cholesterol levels

2. Medications

Blood pressure medications
Diuretics for swelling
Iron supplements or erythropoietin for anemia
Vitamin D or phosphate binders for bone health

Always take medications under medical supervision, especially since many drugs affect the kidneys.

3. Diet and Nutrition

A renal-friendly diet can relieve pressure on the kidneys:

Limit sodium to control blood pressure
Reduce protein to lower waste buildup
Limit potassium and phosphorus if levels are high
Stay hydrated, but don’t overdo fluids

Consulting a renal dietitian is highly recommended.

4. Lifestyle Changes

Stop smoking
Exercise regularly to maintain weight and heart health
Avoid alcohol or limit intake
Monitor over-the-counter medications (especially NSAIDs)

Monitoring and Follow-up

Routine check-ups are crucial in Stage 3 CKD:

Regular GFR and creatinine tests
Blood pressure checks
Urine protein screening
Monitoring for anemia, calcium, and phosphate levels

Early detection of complications can prevent further damage.

Emotional and Psychological Impact

Living with chronic kidney disease can be stressful. Many patients experience anxiety or depression, especially after diagnosis. Support from family, healthcare providers, or counseling services can help.

Joining CKD support groups, either locally or online, can also provide emotional support and practical advice.

When to See a Nephrologist

In Stage 3, a referral to a nephrologist (kidney specialist) is often recommended, especially in Stage 3b or if GFR continues to decline. Early specialist care can delay the need for dialysis or transplant.

Prognosis and Life Expectancy

Many people with chronic kidney disease Stage 3 live long, fulfilling lives with proper management. The progression rate varies depending on age, other health conditions, and lifestyle choices. With active care, many patients never reach kidney failure.

How Serious is Grade 3 Kidney Disease?

Moderately Serious: Stage 3 CKD indicates kidney function is reduced to 30–59% of normal.
Permanent Damage: At this stage, kidney damage is permanent, but further decline can be prevented with management.
Divided into Two Sub-stages:
- Stage 3a: GFR 45–59
- Stage 3b: GFR 30–44
Symptoms:
- Fatigue, swelling, changes in urination, back pain, and high blood pressure.
- Some people may have no symptoms in early Stage 3.
Risk of Progression: If unmanaged, Stage 3 can progress to Stage 4 or 5, which can lead to kidney failure requiring dialysis or a transplant.
Treatment:
- Blood pressure and blood sugar control (especially if diabetic).
- Kidney-friendly diet, limiting salt, protein, potassium, and phosphorus.
- Avoid medications harmful to kidneys.
- Regular check-ups with a nephrologist.
Prognosis: With early intervention, people can live well with Stage 3 CKD and prevent further damage.

How to Treat Stage 3 Kidney Disease

Treating Stage 3 chronic kidney disease (CKD) is crucial to prevent further kidney damage and manage symptoms. At this stage, kidney function is moderately reduced (GFR between 30 and 59), so proper management can significantly slow the progression of the disease.

Here’s how Stage 3 CKD is typically treated:

1. Control Underlying Conditions

Manage Diabetes: High blood sugar can damage the kidneys, so keeping blood glucose levels within the target range is essential. Medications like insulin or oral diabetic drugs may be prescribed.
Control Blood Pressure: High blood pressure can worsen kidney damage. Medications like ACE inhibitors or angiotensin II receptor blockers (ARBs) are often prescribed to lower blood pressure and protect the kidneys.

2. Diet Modifications

Low-Sodium Diet: Reducing salt intake helps control blood pressure and prevents fluid buildup. Aim for less than 2,300 mg of sodium daily.
Reduce Protein Intake: Excessive protein can cause waste buildup in the blood. A renal dietitian can help you determine how much protein is safe.
Limit Potassium and Phosphorus: High levels of potassium and phosphorus can occur with kidney disease. Foods rich in these minerals, like bananas and dairy, may need to be limited.

3. Medication Management

Diuretics: These medications help reduce swelling and fluid retention, which is common in CKD.
Phosphate Binders: If phosphorus levels are high, phosphate binders may be prescribed.
Iron Supplements: Anemia, common in kidney disease, can be managed with iron supplements or erythropoiesis-stimulating agents.

4. Regular Monitoring

Regular check-ups are essential to monitor kidney function. Blood tests for creatinine, GFR, potassium, and phosphorus levels help track kidney health.

5. Lifestyle Changes

Quit Smoking: Smoking accelerates kidney damage and raises blood pressure.
Exercise: Regular physical activity helps maintain a healthy weight, lowers blood pressure, and improves heart health.

6. Work with a Nephrologist

A nephrologist (kidney specialist) plays a key role in managing Stage 3 CKD. They monitor kidney function, adjust medications, and provide guidance on preventing further damage.

Conclusion

Chronic kidney disease Stage 3 is a pivotal stage where proper management can make a big difference. Though kidney function is moderately reduced, many people can maintain a good quality of life and avoid further progression. With the right medical care, lifestyle changes, and support, Stage 3 CKD does not have to define your future.

FAQs: Chronic Kidney Disease Stage 3

What is Stage 3 chronic kidney disease?
It’s a moderate stage of CKD where kidney function is reduced (GFR 30–59), but not yet severe.
Is Stage 3 CKD serious?
Yes, it’s serious but manageable. Early treatment can prevent progression to later stages.
Can Stage 3 CKD be reversed?
No, but it can be slowed or stabilized with medication, diet, and lifestyle changes.
What are the symptoms of Stage 3 CKD?
Fatigue, swelling, changes in urination, back pain, and muscle cramps are common.
Do I need dialysis in Stage 3 CKD?
No dialysis is needed at this stage unless it progresses to Stage 5.
How is CKD Stage 3 diagnosed?
Through blood tests (e.g., creatinine, GFR), urine tests, and imaging studies.
What foods should I avoid in Stage 3 CKD?
Limit sodium, potassium, phosphorus, and excess protein. A renal dietitian can guide you.
Can I live a normal life with Stage 3 CKD?
Yes, with regular check-ups and healthy habits, many people live well with Stage 3.
Should I see a kidney specialist?
Yes, especially if you’re in Stage 3b or showing complications.
Is chronic kidney disease the same as kidney failure?
No. CKD is a gradual decline in kidney function. Kidney failure is the final stage (Stage 5).