Stage 3 chronic kidney disease (CKD)

In Stage 3 CKD, your eGFR is between 30 and 59. You may also have protein in your urine (i.e., your pee). Your kidneys have damage that affects how well they work, and you may start to notice symptoms. This damage normally is not 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
kidney illustration red

What is Stage 3 CKD?

In Stage 3 CKD, your kidneys have mild to moderate damage, and they are less able to filter waste and fluid out of your blood. This waste can build up in your body and begin to harm other areas, such as to cause high blood pressure, anemia and problems with your bones. This buildup of waste is called uremia.

Stage 3 CKD is split into 2 sub-stages based on your eGFR:

Stage 3a means you have an eGFR between 45 and 59, and Stage 3b means you have an eGFR between 30 and 44. 

How serious is Stage 3 CKD?

You might think of Stage 3 CKD as a "middle stage" of kidney disease. Your kidneys are damaged, but they still work well enough that you do not need dialysis or a kidney transplant.

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. 

What are the symptoms of Stage 3 CKD?

Some people with Stage 3 CKD do not have any symptoms. But for many people with CKD, Stage 3 is when their kidney disease begins to affect their health, and they start to notice symptoms.

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
white man getting blood test

How can doctors tell my stage of CKD?

It is common for people to find out they have CKD when they are in Stage 3 because this is when many people first have symptoms of kidney disease.

To find out what stage of CKD you are in, doctors will do tests, such as:

eGFR blood tests
Urine tests

How can doctors tell what caused my CKD?

To try and 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)

How do doctors treat Stage 3 CKD?

Doctors treat Stage 3 CKD with medicines that help with your symptoms and with other health problems kidney disease can cause, 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 do lab tests to check your kidney health often, usually every 90 days (about three months).

How can I slow down the damage to my kidneys?

Healthy life changes can make a big difference in how you feel and can help keep your kidneys working well for as long as possible. Eating kidney-friendly foods in the right amounts is one of the best ways to slow the damage to your kidneys from CKD and to feel your best. A  dietitian is a nutrition expert who can look at results from your lab tests and help you plan healthy meals and snacks you'll want to eat: your "kidney diet."

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.