No, Stage 3 CKD does not always get worse; it's a "middle stage" where many people can stabilize their kidney function, especially with treatment and lifestyle changes, though some progression to later stages can occur, particularly with higher albumin levels, but early diagnosis and management significantly reduce risk.
Conclusions: About half of the patients with stage 3 CKD progressed to stage 4 or 5, as assessed by eGFR, over 10 years. Degree of albuminuria, stage 3 subgroup and microscopic haematuria were important risk factors for progression of 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).
In stage 3a CKD, you are at increased risk for your CKD getting worse and you are at risk for heart disease (even if your uACR is lower than 30). As your uACR number goes up, your risks of developing heart disease and CKD progression (worsening) both go up dramatically (as seen in the figure below).
At 40 years of age, the average life expectancy is: 24.5 years for males with stage 3a CKD. 28.7 years for females with stage 3a CKD. 14.5 years for males with stage 3b CKD.
Although Stage 3 kidney disease is not terminal, knowing how to cope with it is key to maintaining good health. WebMD reported, “all-cause mortality rate varied from 6% in 3 years to 51% in ten years.”
The protein recommendation for CKD stage 3 is 0.55-0.6 grams of protein per day per kilogram body weight if you do not have diabetes.
The good news is that with treatment and lifestyle changes, most people stay stable at stage 3 and their CKD doesn't get worse. Most people diagnosed with CKD stages 1-3 will never need to see a kidney specialist and will remain under the care of their GP. Less than 2% of people who have CKD will ever need dialysis.
Seeing a doctor when you have stage 3 CKD
As stage 3 progresses, a patient should see a nephrologist (a doctor who specializes in treating kidney disease). Nephrologists examine patients and perform lab tests so they can gather information about their condition to offer the best advice for treatment.
Stage 3b CKD means moderate to severe kidney function loss. Symptoms include fatigue, swelling, and nausea. Regular checkups and lifestyle changes can help manage it.
Sleep disorders, are common in people with chronic kidney disease and end stage renal disease. In addition to insomnia, sleep-disordered breathing, excessive sleepiness, and restless leg syndrome many have a high incidence of sleep apnea and periodic limb movements in sleep.
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Eat a kidney-friendly diet and exercise regularly.
A dietitian can help you plan meals that you like based on your preferences. Regular exercise and maintaining a healthy weight are also effective ways to help manage your disease progression. Talk to your doctor about incorporating exercise into your daily routine.
INTRODUCTION. With prevalence studies currently estimating that around 5% of the adult population will have evidence of stage-3 or 'moderate' chronic kidney disease (CKD),1–7 the last 5 years has seen CKD become a major healthcare challenge.
Most people with CKD will be able to control their condition with medicine and regular check-ups. CKD only progresses to kidney failure in around 2 in 100 people with the condition.
Limiting salt and high-sodium foods reduces hypertension, assists blood pressure medications to work more effectively and treats fluid retention. The sodium recommendation for stage 3 CKD is 1,000 to 4,000 mg/day. Speak with your doctor or dietitian to determine your recommended daily amount.
Indications for Nephrology Referral
For patients with progressive CKD, referral to a nephrologist for renal replacement therapy is essential when the risk of renal failure within one year is 10% to 20%. Validated risk calculators for progression to end-stage renal disease are available.
Symptoms of stage 3 CKD
Fluid retention, swelling (edema) of extremities and shortness of breath: Urination changes (foamy; dark orange, brown, tea-colored or red if it contains blood; and urinating more or less than normal) Kidney pain felt in their back. Sleep problems due to muscle cramps or restless legs.
ACE inhibitors and ARBs have been shown to slow the progression of CKD, particularly in patients with albuminuria. These medications lower glomerular capillary blood pressure as well as systemic blood pressure.
In large, population-based studies with long-term follow-up, a proportion of patients with CKD undergo regression or remission over time. The likelihood of remission, however, is strongly associated with the presence and severity of albuminuria.
If ACR is less than 70 mg/mmol — aim for a clinic systolic blood pressure below 140 mmHg (target range 120–139 mmHg) and diastolic blood pressure below 90 mmHg. If ACR is 70 mg/mmol or more — aim for a clinic systolic blood pressure below 130 mmHg (target range 120–129 mmHg) and diastolic blood pressure below 80 mmHg.
There's no medicine that can cure CKD, but medicine can help control many of the problems that cause the condition, the complications that can happen as a result of it and keep the kidneys working for longer. You may need to take medicine to treat or prevent the different problems caused by CKD.
When your kidneys don't work well, the phosphorus can build up in your blood and lead to bone problems. Eating lean, high-quality protein can help you get the right amount of protein-without too much fat or phosphorus. Some good choices include fish, chicken, lean red meat, a bit of low-fat dairy, and eggs.
While many cheeses are high in phosphorus and sodium, there are lower phosphorus and sodium cheeses more suitable for people with kidney disease. Most cheeses are also high in saturated fat; but lower-fat versions of many cheeses are available.
To strengthen your kidneys, focus on a healthy lifestyle: stay hydrated with water, eat a balanced diet low in salt and processed foods, exercise regularly, avoid smoking and excessive alcohol, manage blood pressure and sugar, limit over-the-counter pain relievers (like NSAIDs), and maintain a healthy weight to support overall kidney function.