Stage 3 chronic kidney disease (CKD) causes, symptoms and treatment
In Stage 3 CKD, your eGFR is between 30 and 59. You may also have a protein called albumin in your urine (i.e., your pee). Kidney damage affects how well they work, and you may start to notice symptoms. Kidney damage isn't usually reversible, but there's a lot you can do to slow further kidney damage.
- Medically reviewed by
- AKF's Medical Advisory Committee
- Last updated
- October 20, 2022
What is Stage 3 CKD?
In Stage 3 CKD, your kidneys have mild to moderate damage and are less able to filter waste and fluid out of your blood. Waste buildup or uremia can build up in your body and lead to complications, such as high blood pressure, anemia, and problems with your bones.
Stage 3 CKD is split into two sub-stages based on your eGFR:
- Stage 3a means you have an eGFR between 45 and 59 Stage
- 3b means you have an eGFR between 30 and 44
How serious is Stage 3 CKD?
Think of Stage 3 CKD as the "middle stage" of kidney disease. Your kidneys are damaged, but you don't need dialysis or a kidney transplant. In this stage, it's important to monitor not just your kidney function but also the levels of albumin in your urine, measured by the urine albumin-to-creatinine ratio (uACR). This test helps determine if your kidneys are filtering correctly. A higher uACR stage means more albumin is present in your urine, which indicates more significant kidney damage.
Kidney disease often cannot be cured in Stage 3, and damage to your kidneys normally is not reversible. However, with treatment and healthy life changes, many people in Stage 3 do not move to Stage 4 or Stage 5, which is kidney failure.
The higher your uACR stage, the greater your risk of kidney disease progressing and complications like heart disease. Understanding your albumin levels, alongside your eGFR, helps you and your doctor plan the best strategy for managing your kidney health and reducing future risks.
Even though there is no cure for CKD, and kidney damage typically isn't reversible, with treatment, healthy life changes, and keeping an eye on your eGFR and UACR, many people in Stage 3 do not move to Stage 4 or Stage 5 (kidney failure).
What are the symptoms of Stage 3 CKD?
Some people with Stage 3 CKD don't have any symptoms. However, stage 3 is usually when kidney disease begins to affect your health, and you'll start to notice symptoms. It's important to remember that even if you don't have symptoms, regular monitoring is important for early detection. If you're considered high-risk for kidney disease — such as having diabetes, high blood pressure, or a family history of kidney disease — your doctor may recommend more frequent testing to help keep track of your kidney health.
Symptoms of Stage 3 CKD may include:
- Feeling weak and tired
- Swelling in your hands or feet
- Skin that feels dry or itchy
- Pain in your lower back
- Muscle cramps
- Trouble sleeping
- Restless leg syndrome (an uncomfortable feeling in your legs that makes it hard to sit still or fall asleep)
- Urinating more or less often than normal
- Urine that is foamy or darker in color than usual
How can doctors tell my stage of CKD?
Your doctor may test the health of your kidneys even without symptoms if you have a family history of kidney disease or a health condition that can damage your kidneys, such as diabetes or high blood pressure.
How can doctors tell what caused my CKD?
To find out what caused your CKD, your doctor may do other tests, including:
- Blood pressure checks
- Urine tests
- Imaging tests to take detailed pictures of the inside of your body, such as ultrasound, CT scan, or MRI
- Kidney biopsy (a procedure where doctors take a small piece of tissue from your kidneys to look at it under a microscope)
- Genetic testing (if doctors suspect a rare disease or one that runs in your family)
For Stage 3 CKD, annual checkups are important to evaluate how well your kidneys work, reassess your treatment plan, check for signs of complications, and ensure you manage your condition effectively.
Understanding the cause of your kidney disease is an important step in managing your health. Don't hesitate to ask your doctor about the underlying reasons for your condition.
Ask if additional tests are necessary to determine the root cause or to understand your kidney function better. Be proactive, take charge of your health, and make informed decisions about your care.
How do doctors treat Stage 3 CKD?
Doctors treat Stage 3 CKD with medicines that help with your symptoms and related health conditions, such as diabetes and high blood pressure.
These medicines include:
- Blood pressure medicines like ACE inhibitors and ARBs (even if you do not have high blood pressure, these medicines can help slow the damage to your kidneys to keep them working well as long as possible)
- Diabetes medicines to keep your blood sugar at a healthy level (even if you do not have diabetes)
- Calcium and vitamin D supplements to keep your bones strong
- Diuretics to help with swelling (these are medicines that help your kidneys get rid of salt and water and make you urinate more)
- Iron supplements to help with anemia (not enough red blood cells in your body)
You may also need to stop taking certain medicines that can worsen the damage to your kidneys, such as pain medicines called NSAIDs (nonsteroidal anti-inflammatory drugs) and some arthritis medicines. Tell your doctor about all the medicines you take–even ones they did not prescribe.
If you do not have a nephrologist (kidney doctor), talk to your regular doctor about finding one. You and your nephrologist can work together to make a treatment plan just for you.
Your nephrologist will also run tests to check your kidney health regularly, usually every three months.
Manage CKD with a healthy lifestyle
Following a kidney-friendly meal plan is one of the best ways to slow kidney damage and feel your best. A dietitian (nutrition expert) can look at your lab results and help you plan healthy meals and snacks you'll want to eat.
Here are other healthy changes that will help slow the damage to your kidneys:
- Be active for at least 30 minutes on most days of the week. This can be anything from walking or riding a bike to swimming or dancing.
- If you have diabetes, follow your treatment plan to keep your blood sugar within your target range.
- Quit smoking or using tobacco.
