What Is Stage 3 Kidney Disease?

There are five stages of chronic kidney disease—a kidney condition that occurs when you've been experiencing damage and loss of kidney function for at least three months. During stage 3 kidney disease, your kidneys are considered moderately damaged. But, it's worth noting that they are still able to function somewhat normally.

Roughly 6% of adults in the U.S. have stage 3 kidney disease. Most people start to notice early symptoms of their condition during stage 3. Oftentimes, these symptoms can be very subtle. People with stage 3 kidney disease don’t have to be on dialysis yet, but some will eventually this treatment to help clean and filter the blood when their kidneys are no longer able to.

Stage 3 Symptoms

Early on, chronic kidney disease often doesn’t cause any symptoms. It's not until stage 3 kidney disease that symptoms become noticeable. You might start to notice symptoms at this stage because moderate damage to the kidneys can make it difficult for your body to get rid of excess fluid and substances through your urine. Your body may also not be producing enough erythropoietin—a hormone that plays a role in producing red blood cells.

During this stage, you may start to feel the following symptoms:

• Anemia
• Fatigue
• Muscle cramps
• Poor appetite
• Nausea and vomiting
• Difficulty sleeping
• Bone or joint pain
• Urinating more or less than normal
• Swollen ankles
• Puffy eyes
  

It's worth noting that not everyone experiences symptoms during this stage. Each person's journey with kidney disease can look different. Some people may not have any symptoms at all, whereas others may have mild to moderately severe symptoms.

Causes

Several underlying health conditions and lifestyle habits can increase your risk of developing stage 3 kidney disease. The two most common conditions that can cause kidney disease include:

• Diabetes: This condition is the most prevalent cause of chronic kidney disease. About 40% of people with diabetes eventually develop chronic kidney disease, although not all of them get stage 3 disease. High amounts of blood glucose (blood sugar) can damage blood vessels in the kidneys.
• High blood pressure: Having high blood pressure can also damage the blood vessels in your kidneys, making it harder for them to remove excess water and waste.

Other conditions that may boost your risk for kidney disease include:

• Kidney infection and genetic kidney diseases (such as Alport syndrome or polycystic kidney disease)
• Autoimmune disorders such as lupus
• Vasculitis
• Congenital (present at birth) kidney malformations
  

Risk Factors

Aside from having certain medical conditions, the following factors may also increase your risk of experiencing the condition:

• Eating a diet high in sodium (salt)
• Smoking cigarettes
• Not getting enough sleep or exercise throughout the week
  

Diagnosis

If you think you're experiencing symptoms of stage 3 kidney disease, it's good practice to visit your healthcare provider for a proper diagnosis. During your appointment, they will ask about your medical history and perform a physical exam to learn more about your symptoms. Your provider will likely also order other testing measures, such as the eGFR and certain blood tests.

eGFR

A measurement called the estimated glomerular filtration rate (eGFR) is a common test for diagnosing kidney disease and assessing how severe your condition may be. Your provider will use a sample of your blood to assess how quickly and effectively your glomeruli are working. Your glomeruli are tiny components in your kidneys that filter waste and fluids out of the blood.

Each person's eGFR can often vary based on factors like sex and age. Generally, most people without kidney disease have an eGFR of at least 90 milliliters per minute (mL/min). Here's what your eGFR can look like during each stage of kidney disease:

It's important to note that sometimes your healthcare provider may say that you have stage 3A or 3B kidney disease. Stage 3A is less severe, meaning you have an eGFR of 45 to 59 mL/min. Stage 3B is more severe and indicates a greater loss in kidney function, meaning your eGFR result may be between 30 and 44 mL/min.

Additional Tests

Aside from the eGFR, your provider can also order other tests to learn more about your condition. These include:

• Urine albumin-creatine ratio (uACR): Checks for protein levels in your urine
• Complete blood count blood tests: Assesses the presence of anemia
• Metabolic panel blood tests: Measures your body's overall fluid balance and kidney and liver health
• Vitamin D and parathyroid hormone: Monitors bone and mineral abnormalities
• Electrocardiogram (ECG/EKG): Looks for any concerns with your heart rhythm, a potential complication of chronic kidney disease

Treatment

Your healthcare provider cannot reverse kidney damage that occurs during stage 3 kidney disease. However, you can take steps to slow the progression of your condition and prevent disease complications from occurring.

Your exact treatment plan will depend on your overall health and the severity of your symptoms. Your healthcare provider may recommend the following medications:

• Statin drugs to reduce the risk of heart complications
• Drugs to lower blood pressure, such as ACE inhibitors like Capoten (captopril)
• Iron pills to increase the production of red blood cells if you have anemia
• Insulin to decrease high blood sugar caused by diabetes

Aside from medication, your healthcare provider may also suggest practicing certain lifestyle habits to reduce symptoms, improve underlying causes of kidney disease (e.g., high blood pressure or diabetes), and prevent complications. These include:

• Limiting intake of alcohol and tobacco
• Eating a diet low in sodium
• Drinking enough water throughout the day
• Moving your body or participating in some physical activity daily
  

How to Prevent Kidney Disease Progression

If you already have chronic kidney disease, you might not be able to keep it from progressing completely. However, you can take steps to help it progress more slowly. Some ways to slow down your condition include:

• Limiting the use of any medications that can affect kidney function, such as nonsteroidal anti-inflammatory drugs like Advil (ibuprofen)
• Asking for support on how to quit smoking
• Staying hydrated
• Working with your healthcare provider to manage underlying health conditions that may contribute to your kidney-related symptoms

Related Conditions

People with chronic kidney disease have an increased risk of developing conditions that affect the heart and blood vessels—such as a heart attack or stroke. This risk is greatest for people who have severe chronic kidney disease, like stage 4 or 5 disease. However, even people with stage 3 disease may have a higher risk of experiencing these conditions.

Living With Stage 3 Kidney Disease

For those living with stage 3 kidney disease, the condition hasn't affected kidney function greatly. In fact, you may have just started noticing symptoms or recently received your diagnosis. It can be difficult to get a kidney disease diagnosis—and it's OK to feel however you feel. However, it is vital to manage the condition early to reduce the risk of your disease progressing.

One study found that only 4% of people with stage 3 kidney disease need dialysis 10 years later. But people with stage 3 kidney disease have a moderately high risk of eventually needing dialysis, with the greatest risks for people who already have stage 3B disease. That's why following your treatment plan and implementing certain lifestyle changes can decrease your risk of long-term complications.