What Does CKD Stage 3 Mean?

If you have been told that you have stage 3 chronic kidney disease (CKD), you may be wondering what this means and whether you should be worried. Stage 3 CKD means that your kidneys are working less efficiently than normal, but it does not mean that your kidneys are failing or that you need dialysis.

In fact, many people with stage 3 kidney disease can maintain stable kidney function for years. The goal is to understand why your kidney function is reduced, identify factors that could cause further damage, and take steps to protect your kidneys for the future.

What is chronic kidney disease?

Chronic kidney disease means there has been a persistent change in kidney function or evidence of kidney damage for at least three months.

One of the main measurements used to evaluate kidney function is the estimated glomerular filtration rate (eGFR). Your eGFR is calculated from a blood test and provides an estimate of how well your kidneys are filtering your blood.

Stage 3 CKD is divided into two categories:

• Stage 3a CKD: eGFR of 45–59

• Stage 3b CKD: eGFR of 30–44

An eGFR below 60 does not always mean you have chronic kidney disease. Kidney function can temporarily decrease because of dehydration, illness, certain medications, or other factors. This is why your doctor will usually look at your kidney function over time rather than relying on a single blood test.

Is stage 3 kidney disease serious?

Stage 3 CKD is an important finding, but it does not necessarily mean that your kidney disease will continue to worsen.

Some people remain in stage 3 for many years without significant progression. Others may be at higher risk of losing kidney function over time.

Your individual risk depends on much more than your eGFR alone.

One of the most important factors is the amount of protein or albumin in your urine. Higher levels of protein in the urine can indicate kidney damage and are associated with a greater risk of kidney disease progression.

Other factors such as diabetes, high blood pressure, cardiovascular disease, smoking, and the underlying cause of your kidney disease can also affect your risk.

What causes stage 3 CKD?

There are many possible causes of chronic kidney disease. Some of the most common include:

• Diabetes

• High blood pressure

• Protein in the urine (proteinuria or albuminuria)

• Certain autoimmune diseases

• Polycystic kidney disease

• Recurrent kidney stones or urinary obstruction

• Previous episodes of severe acute kidney injury

• Certain medications or long-term medication exposure

Sometimes, more than one factor contributes to reduced kidney function.

Determining why your kidney function is reduced is an important part of deciding how to protect it.

What symptoms occur with stage 3 CKD?

Many people with stage 3 CKD have no symptoms at all.

Kidney disease is often discovered during routine blood or urine testing. This is one reason CKD can go unnoticed for years.

As kidney disease progresses, some people may develop symptoms such as swelling in the legs, fatigue, changes in urination, or difficulty controlling blood pressure. However, symptoms alone are not a reliable way to determine how well your kidneys are functioning.

Can stage 3 CKD be treated?

There is no single treatment for CKD. Treatment depends on the cause of your kidney disease and your individual risk factors.

Kidney-protective care may include:

• Keeping blood pressure well controlled

• Treating diabetes when present

• Reducing protein loss in the urine

• Using kidney-protective medications when appropriate

• Avoiding medications or supplements that could harm the kidneys

• Reducing excess dietary sodium

• Maintaining a healthy weight

• Treating cardiovascular risk factors

• Monitoring kidney function and urine protein over time

Certain medications, including ACE inhibitors or ARBs, SGLT2 inhibitors, and other kidney-protective therapies, may significantly reduce the risk of kidney disease progression in appropriate patients.

The right treatment depends on your medical history, kidney function, urine protein levels, blood pressure, and other health conditions.

Does stage 3 CKD mean I will need dialysis?

No.

Being diagnosed with stage 3 CKD does not mean that dialysis is inevitable.

Many people with stage 3 kidney disease never progress to kidney failure. The likelihood of progression depends on the underlying cause of kidney disease, how quickly kidney function is changing, the amount of protein in the urine, and other health conditions.

Early identification and appropriate treatment can help slow kidney disease progression and reduce cardiovascular risk.

Should I see a nephrologist for stage 3 CKD?

A nephrologist is a physician who specializes in kidney disease.

A nephrology evaluation may be particularly helpful if you have:

• Stage 3b CKD

• Kidney function that is declining over time

• Moderate or severe protein in the urine

• Difficult-to-control high blood pressure

• Blood or other abnormalities in the urine

• Recurrent electrolyte abnormalities

• An unclear cause of kidney disease

• A family history of inherited kidney disease

A nephrologist can help determine the cause of reduced kidney function, estimate your risk of progression, and develop an individualized plan to protect your kidneys.

The most important thing to know about stage 3 CKD

Your eGFR is important, but it is only one part of the picture.

Two people with the same eGFR can have very different kidney health and very different risks of progression. Looking at your kidney function over time, measuring protein in your urine, identifying the cause of kidney disease, and addressing modifiable risk factors provides a much clearer picture.

If you have recently been diagnosed with stage 3 CKD, this can be a good time to learn more about your kidney health and what you can do to protect your kidney function.

Kidney Care in Sherwood and the Portland Metro

Marilia Campos, MD is a board-certified nephrologist at Optima Kidney Care in Sherwood, Oregon, providing individualized kidney care for patients throughout Sherwood, Tualatin, Tigard, Wilsonville, Lake Oswego, Beaverton, Portland, and surrounding communities.

Optima Kidney Care evaluates and treats chronic kidney disease, proteinuria, difficult-to-control high blood pressure, diabetic kidney disease, kidney stones, and other kidney-related conditions.

If you have been diagnosed with stage 3 CKD or have questions about a low eGFR, you can schedule a consultation with Optima Kidney Care to better understand your kidney health and develop a personalized plan to protect your kidneys.

This article is for educational purposes and is not a substitute for individualized medical advice.