Stage 3 Chronic Kidney Disease: What to Expect

Chronic kidney disease (CKD) occurs when the kidneys are damaged and no longer filter blood the way they should. The kidneys are responsible for removing extra water and waste from the blood to produce urine.

The kidneys also balance salts and minerals, produce hormones that help regulate blood pressure, keep bones strong, and make red blood cells.

In chronic kidney disease, damage to the kidneys happens over a period of time. This damage can occur due to a variety of reasons. People who have high blood pressure, diabetes, heart disease, or a family history of kidney disease are more likely to develop CKD.

Chronic kidney disease is categorized into five stages. An early diagnosis of CKD can help preserve kidney function and slow progression to the later stages.

This article discusses the stages of chronic kidney disease, what having stage 3 means, the symptoms related to stage 3, how to stop progression, and life expectancy.

Middle-aged man being examined by a female doctor in a doctor's office. Patient complains to the doctor of kidney pain.

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Stages of Chronic Kidney Disease

There are five stages of chronic kidney disease. In stages 1 through 3, the early stages, the kidneys are still able to filter waste from the blood. In the later stages, stages 4 and 5, the kidneys have to work much harder to eliminate waste and may stop functioning entirely.

Each chronic kidney disease stage is based on estimated glomerular filtration rate (eGFR) test results. The kidneys have small filters known as glomeruli that help remove excess water and waste from the blood.

The eGFR test is a blood test that measures how well the kidneys function. GFR is an estimate of how much volume (of blood) the kidneys are able to successfully filter per minute of time.

This is estimated by measuring particular waste molecules in the bloodstream. The most frequently used one is called creatinine (not to be confused with creatine). The higher the level of creatinine in the blood, the more likely that the kidney's ability to filter (and therefore function) has become impaired.

Test results determine the stage of CKD. Each stage is associated with an eGFR result as follows:

  • Stage 1: eGFR is 90 or higher
  • Stage 2: eGFR is 60–89
  • Stage 3a: eGFR is 45–59
  • Stage 3b: eGFR is 30–44
  • Stage 4: eGFR is 15–29
  • Stage 5: eGFR is less than 15

Stage 3 Chronic Kidney Disease

Stage 3 chronic kidney disease is considered the middle stage. In stage 3 chronic kidney disease, there is mild to moderate damage to the kidneys, and the kidneys don’t filter waste and fluid as well as they should.

This waste and fluid may build up in the body and cause problems such as high blood pressure. Also, the decrease in viable kidney cells at this stage impairs their role in promoting healthy production of red blood cells, causing anemia, as well as their role in bone metabolism, causing problems in bone structure and metabolism which can lead to fractures.

While damage to the kidneys usually is not reversible, treatment and healthy lifestyle changes can slow the progression. With proper treatment, many people do not progress to stages 4 or 5, which is kidney failure.

Stage 3 Symptoms

While some people do not experience symptoms in stage 3, this stage is often when symptoms first appear. In fact, many people only discover they have chronic kidney disease when they reach stage 3 and experience symptoms.

Symptoms of stage 3 chronic kidney disease include:

  • Swelling in the hands and feet
  • Fatigue, or feeling weak and tired
  • Dry or itchy skin
  • Pain in the lower back
  • Muscle cramps
  • Trouble sleeping
  • Urinating more or less often than normal
  • Foamy or darker than normal urine
  • Restless legs syndrome (RLS), an uncomfortable feeling in the legs that makes it hard to sleep or sit still

Stopping the Progression

Though chronic kidney disease cannot be reversed, there are steps to take to prevent further damage to the kidneys. These steps can improve overall health and may also prevent heart disease.

Even if you are not experiencing symptoms, it’s important to follow your prescribed treatment plan to slow or stop the progression of the disease.

Diet

Making changes to your diet can help you live well with chronic kidney disease. These changes can help manage the disease and prevent further damage to the kidneys.

Dietary changes you can make include:

  • Limit sodium: Choose foods with less salt. Buy fresh foods and cook from scratch. Packaged and prepared goods tend to have added sodium. Look for foods labeled "low salt," "low sodium," "unsalted," or "lightly salted."
  • Choose proteins wisely: Protein comes from poultry, meat, eggs, dairy, fish, beans, nuts, and grains. When you consume protein, your body produces waste that must be filtered by the kidneys. Eating more protein than you need can force the kidneys to work harder. Make sure you are eating proper serving sizes. Talk to a dietitian about the right combination of proteins for you.
  • Eat heart-healthy foods: Add fruits, vegetables, beans, fish, low-fat dairy, lean meats, and poultry without skin to your diet. Avoid fried foods and opt for grilled or baked options. Limit saturated and trans fats. Cook with nonstick cooking spray or a small amount of olive oil instead of butter.

Lifestyle

Lifestyle changes can improve your overall health and help to slow the progression of kidney disease. These changes include:

  • Aiming for a healthy weight.
  • Remaining physically active or beginning a physical activity routine.
  • Getting enough sleep
  • Stopping smoking
  • Managing stress

Medical Treatment

Medical management for any stage of CKD will include:

Treating underlying conditions: If the condition causing the decrease in GFR is reversible, efforts should be made to address it. Examples of reversible or treatable conditions that can cause renal failure include:

  • Obesity
  • Diabetes
  • Hypertension
  • Heart failure
  • Autoimmune kidney disease (e.g., lupus, IgA nephropathy)
  • Hepatitis C
  • HIV (human immunodeficiency virus)
  • Stopping medications or drugs that impair kidney function, including nonsteroidal anti-inflammatory drugs (NSAIDs, such as Advil ibuprofen and Aleve naproxen sodium), some antihypertensives, tobacco, and cocaine

Medications that can help curb the deterioration in kidney function include:

  • A group of medications called ACE (angiotensin-converting enzyme) inhibitors or ARBs (angiotensin receptor blockers) can help delay the progression of kidney failure, particularly in people who are shedding protein in their urine.
  • Another group of medications called SGLT2 (sodium-glucose cotransporter 2) inhibitors, although primarily labeled as a diabetic medication, can (even without a formal diagnosis of diabetes) protect kidney function.

Treating the complications of kidney failure:

  • Although less commonly seen in stage 3 kidney failure, a person will need antihypertensives or diuretics (water pills) to treat water retention due to the decrease in kidney function.
  • Anemia from kidney disease is usually treated with medications that stimulate bone marrow production of red blood cells
  • Bone changes from kidney disease are usually treated with calcium and vitamin D supplements.

Use Caution with Over-the-Counter (OTC) Medications

Taking NSAIDs for pain relief or cold symptoms can cause damage to the kidneys, especially in people with kidney disease, high blood pressure, and diabetes. Talk to your pharmacist or healthcare provider before starting an OTC medication.

Life Expectancy

Life expectancy with chronic kidney disease depends on the age at diagnosis and how damaged the kidneys are.

Being diagnosed with CKD at an older age is associated with a more near-normal life expectancy. A male diagnosed at the age of 65 in stage 3, for instance, could expect to reach average life expectancy of 76 years old.

Higher rates of eGFR (which means being in the lower stages of CKD) are also associated with a longer life expectancy.

Summary

Stage 3 chronic kidney disease is considered a middle stage of the disease and is often associated with symptoms such as fatigue and fluid retention.

Receiving early treatment, adjusting your diet, and making healthy lifestyle changes such as quitting smoking, can help slow the progression of CKD to the later stages. Though there is no cure for CKD, treatment can help you reach near-normal life expectancy.

A Word From Verywell

Though living with a chronic disease like CKD can feel overwhelming, taking small steps to improve your health over time can give you a sense of control.

Talking to your healthcare provider about lifestyle and dietary changes you can make to protect your kidneys and asking questions when you don’t understand can help you gain a solid treatment plan. Remember to keep all appointments with your healthcare provider and always reach out to them if you feel your symptoms have changed.

Living well with chronic kidney disease may take some effort, but following your treatment plan can help prevent you from progressing into later stages of the disease.

Frequently Asked Questions

  • What is the life expectancy of someone with stage 3 chronic kidney disease?

    It varies. Life expectancy depends on the amount of kidney damage and the age at which you reach stage 3. Older people can expect to reach a near-normal life expectancy, while younger people with more kidney damage can expect a significantly lower life expectancy.

  • How long does it take to go from stage 3 to stage 4 of chronic kidney disease?

    Some people will never progress to stage 4, however, one study found that about 50% will move to stage 4 over the course of 10 years.

  • Is chronic kidney disease curable?

    Chronic kidney disease is not curable, however, there are treatment options and lifestyle changes you can make to slow or stop the progression of the disease.

10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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