Stage 3 kidney disease means your kidneys aren’t cleaning waste from your blood as well as they should. At this stage of chronic kidney disease (CKD), you may start to notice swelling, tiredness, or changes in your urine. The good news is that with treatment and healthy lifestyle changes, many people can manage the disease and continue living well.

“I was diagnosed in 2015 with stage 3 chronic kidney disease (CKD). I have watched it diligently since then and have been able to keep it stable,” a MyKidneyDiseaseTeam member shared.

In this article, we’ll explain what stage 3 kidney disease means and practical ways to slow disease progression so you can maintain a healthy lifestyle.

Understanding Stage 3 Kidney Disease

Your kidneys filter excess waste and water from your blood to make urine. They also help keep the right balance of minerals and electrolytes, support bone health, and play a role in making certain blood cells. When the tiny filtering units of the kidneys, called nephrons — especially the glomeruli — are damaged, the kidneys can’t filter as well. Wastes, toxins, electrolytes, and fluid start to build up in the blood, while important substances like protein may leak into the urine.

To check how well your kidneys are filtering and to look for signs of damage, doctors use a blood test called estimated glomerular filtration rate (eGFR). This test measures how many milliliters of blood your kidneys filter each minute per 1.73 square meters of body surface area. The result is based on the level of creatinine (a waste product) in your blood, as well as your age and sex. The lower your eGFR number, the more kidney damage you have, and the higher the stage of kidney disease.

Stage 3 chronic kidney disease is considered the middle stage, and it’s broken into two parts based on your eGFR number:

• Stage 3a — eGFR from 45 to 59
• Stage 3b — eGFR from 30 to 44

At stage 3, your kidneys have moderate damage but still work, just not as well as they should. You won’t need treatments like dialysis or a kidney transplant at this point, but it’s important to take action now to protect your kidney function.

Recognizing the Warning Signs

With stage 1 or stage 2 kidney disease, symptoms usually aren’t noticeable. At stage 3, as wastes and extra fluid build up in your blood, you may start to notice more signs that something isn’t right. These can include:

• Constantly feeling tired or weak
• Edema (swelling) in the face, hands, or feet
• Dry or itchy skin
• Muscle cramps
• Trouble sleeping
• Changes in urination patterns
• Urine that looks darker than usual or foamy
• Lower back pain, particularly near your kidneys

Some people might not have any symptoms at all, which is why seeing your doctor regularly is so important. Your doctor can monitor your eGFR levels and check your urine for a protein called albumin, which may be a sign of further kidney damage.

Reaching a Diagnosis

Your doctor will often start by asking you about your medical history, including symptoms and other health conditions. They may also look at your family history to check for kidney damage.

Several tests can be used to find out what stage your kidney disease is and to see how well your kidneys are working. Some common tests include:

• Blood test — A blood test measures the amount of waste products in your blood, like creatinine and urea.
• Urine tests — These look at the color and appearance of your urine and check for blood and protein, particularly albumin. High levels of protein can indicate kidney damage and help predict how quickly the disease might progress.
• Imaging tests — Ultrasounds, CT scans, or MRIs can show the structure and size of your kidneys and look for abnormalities.
• Kidney biopsy — This test involves examining a small tissue sample under a microscope to help identify the amount of kidney damage and the specific cause of the disease.

Common Causes and Risk Factors

The main causes of kidney disease are diabetes and hypertension (high blood pressure). Over time, these conditions can damage the small blood vessels in your kidneys. Some other causes include:

• Glomerulonephritis (inflammation and damage to the glomeruli, the filtering units of the kidneys)
• Polycystic kidney disease, an inherited disease that leads to fluid‑filled sacs (cysts) forming in the kidneys
• Autoimmune conditions such as lupus, which can affect the kidneys
• Frequent kidney infections, which can cause damage over time
• Blockages in the urinary system, which can stop or slow the normal flow of urine

The risk factors for stage 3 kidney disease include:

• Old age — 60 years or more
• Family history of kidney disease or other genetic conditions
• Certain medications that cause kidney damage, particularly if used for a long time

Some people may develop kidney diseases like complement 3 glomerulopathy (C3G) or immune complex membranoproliferative glomerulonephritis (IC-MPGN). These rare conditions happen when the body’s complement system (a part of the immune system) malfunctions and deposits harmful proteins in the kidneys. To test for these rare types of kidney disease, your doctor may do a kidney biopsy.

Taking Control of Your Health

Although kidney damage usually can’t be reversed, you can take steps to slow its progression and protect your quality of life.

1. Work With Your Healthcare Team

Regular checkups with your doctor are important for keeping track of your kidney health. This is especially important if you don’t have any symptoms but have risk factors like a family history of kidney disease. You may also benefit from seeing a nephrologist, who can provide specialized care. They will prescribe you different medications to protect your kidneys depending on your symptoms, lab results, and the cause of your kidney disease.

2. Adjust Your Diet

Eating a kidney-friendly diet can help reduce the workload on your kidneys. Focus on fresh fruits and vegetables, whole grains, and lean proteins. You may need to limit salt, potassium, calcium, phosphorus, and protein as well. Your doctor or a registered dietitian can help create a plan made just for you. The American Kidney Fund and the National Kidney Fund also provide kidney-friendly recipes for different stages of kidney disease.

3. Stay Physically Active

Regular physical activity can help you feel stronger and may slow kidney disease progression. Aim for about 30 minutes of activity most days of the week. Walking, swimming, cycling, or yoga are a few good choices, but always be sure to ask your doctor which exercises are best for you. You may need to start slow and build up to longer exercise times.

4. Monitor Your Blood Pressure and Blood Sugar

If you have diabetes, high cholesterol, or high blood pressure, keeping these conditions well controlled is one of the most important things you can do for your kidneys. Take medications as prescribed, and monitor your levels regularly. Talk to your doctor if you notice any changes.

5. Manage Any Complications

As kidney function declines, you may develop complications like anemia (low red blood cell count), bone disease, or mineral imbalances. Your doctor can prescribe you medications to manage these issues and help you feel better.

6. Avoid Kidney-Damaging Substances

Over-the-counter pain medications, especially nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or aspirin, can harm your kidneys. Always ask your doctor before taking new medications or supplements, including any vitamin and herbal supplements. If you smoke, quitting can also protect your kidneys and improve your overall health, as smoking makes the kidney damage worse. Limiting alcohol is helpful too, since it can interfere with medicines, raise blood pressure, and make you miss doses.

Talk With Others Who Understand

On MyKidneyDiseaseTeam, the social network for people with kidney disease and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with kidney disease.

What surprised you the most about stage 3 kidney disease? What steps or lifestyle changes have you taken to reduce further kidney damage? Comment below, or start a new conversation on your Activities page.