Moderate Kidney Damage

In stage 3 of chronic kidney disease (CKD), a person experiences moderate kidney damage. This stage is further categorized into two:

Stage 3A: A decrease in glomerular filtration rate (GFR) to 45-59 mL/min.

Stage 3B: A decrease in GFR to 30-44 mL/min.

As kidney function declines, waste products can accumulate in the blood, leading to a condition known as “uremia.” Stage 3 individuals are at a higher risk of developing kidney disease complications, including high blood pressure, anemia (a shortage of red blood cells), and early bone disease.

Symptoms of Stage 3 CKD

Symptoms may begin to manifest in stage 3:

– Fatigue
– Fluid retention, swelling (edema) of extremities, and shortness of breath
– Changes in urination (foamy; dark orange, brown, tea-colored, or containing blood; urinating more or less than normal)
– Kidney pain felt in the back
– Sleep problems due to muscle cramps or restless legs

Consulting a Nephrologist

As stage 3 progresses, it is advisable for patients to consult a nephrologist, a doctor specializing in kidney disease. Nephrologists conduct examinations and lab tests to gather information about the condition and provide the best treatment advice. Their goal is to help patients maintain kidney function for as long as possible.

Dietitian Guidance

Patients in stage 3 may also benefit from consulting a dietitian. Given the critical role of diet in treatment, dietitians review lab results and recommend personalized meal plans. A proper diet can aid in preserving kidney function and overall health.

Stage 3 CKD Diet

A healthy diet for stage 3 CKD may include:

• Consuming high-quality protein and potassium (if blood levels are elevated)
• Incorporating grains, fruits, and vegetables (with normal potassium and phosphorus levels)
• Limiting phosphorus intake to maintain normal PTH levels, prevent bone disease, and preserve kidney function
• Reducing calcium consumption
• Adjusting carbohydrates for those with diabetes
• Decreasing saturated fats to lower cholesterol levels
• Reducing sodium for individuals with high blood pressure or fluid retention by avoiding processed and pre-packaged foods
• Limiting calcium intake if blood levels are elevated
• Taking water-soluble vitamins like vitamin C (100 mg per day) and B complex, or avoiding over-the-counter dietary supplements (unless approved by the nephrologist)

It is beneficial to collaborate with a registered renal dietitian as dietary recommendations may change with evolving CKD stages.

Medications for Stage 3 CKD

Many CKD patients also have diabetes or high blood pressure. Managing glucose levels and maintaining healthy blood pressure can help preserve kidney function. Doctors may prescribe blood pressure medications. Studies indicate that ACE inhibitors and ARBs can slow kidney disease progression, even in diabetes patients without high blood pressure. Patients should consult their doctors regarding all medications and follow prescriptions precisely.

Additional Approaches to Manage Stage 3 CKD

Besides dietary considerations and medication adherence, regular exercise and abstaining from smoking contribute to prolonged kidney health. Patients should discuss exercise plans with their doctors and seek advice on smoking cessation.

Seeking Support for Stage 3 CKD

While kidney disease has no cure, it may be possible to halt or slow its progression. Correct treatment and lifestyle adjustments can often promote long-term kidney health.