Stage 3 kidney disease and congestive heart failure prognosis

Chronic kidney disease (CKD) refers to permanent damage to the kidneys that occurs gradually over time. Further progression may be preventable depending on its stage.

CKD is classified into five different stages, with stage 1 indicating the best function, and stage 5 indicating kidney failure.

Stage 3 kidney disease falls right in the middle of the spectrum. At this stage, the kidneys have mild to moderate damage.

Stage 3 kidney disease is diagnosed by a doctor based on your symptoms as well as lab results. While you can’t reverse kidney damage, you can help prevent damage from worsening at this stage.

Read on to find out how doctors determine CKD stage, what factors affect the outcome, and more.

Stage 3 of CKD is diagnosed based on estimated glomerular filtration rate (eGFR) readings. This is a blood test that measures creatine levels. An eGFR is used to determine how well your kidneys are working at filtering wastes.

An optimal eGFR is higher than 90, while stage 5 CKD presents itself in an eGFR of less than 15. So the higher your eGFR, the better your estimated kidney function.

Stage 3 CKD has two subtypes based on eGFR readings. You may be diagnosed with stage 3a if your eGFR is between 45 and 59. Stage 3b means your eGFR is between 30 and 44.

The goal with stage 3 CKD is to prevent further kidney function loss. In clinical terms, this can mean preventing an eGFR of between 29 and 15, which indicates stage 4 CKD.

It’s important to see a doctor right away if you experience any of the above symptoms. While certain symptoms aren’t exclusive to CKD, having any combination of these symptoms is concerning.

You should follow up with your doctor if you’ve previously been diagnosed with stage 1 or stage 2 CKD.

Still, it’s possible to not have any previous history of CKD before getting diagnosed with stage 3. This could be due to the fact that stages 1 and 2 don’t typically cause any noticeable symptoms.

To diagnose CKD stage 3, a doctor will conduct these tests:

• blood pressure readings
• urine tests
• eGFR tests (done every 90 days after your initial diagnosis)
• imaging tests to rule out more advanced CKD

Kidney disease can’t be cured, but stage 3 means you still have an opportunity to prevent further progression of kidney failure. Treatment and lifestyle changes are essential at this stage. Your doctor will talk to you about using a combination of the following treatment measures.

Stage 3 kidney disease diet

Processed foods are extremely hard on the body. Since your kidneys are responsible for removing wastes and balancing electrolytes, eating too many of the wrong foods can overload your kidneys.

It’s important to eat more whole foods like produce and grains, and to eat fewer processed foods and less of the saturated fats found in animal products.

A doctor may recommend decreasing your protein intake. If your potassium levels are too high from CKD, they may also recommend that you avoid certain high-potassium foods like bananas, potatoes, and tomatoes.

The same principle pertains to sodium. You may need to cut down on salty foods if your sodium levels are too high.

Weight loss is common in more advanced stages of CKD because of appetite loss. This can also put you at risk of malnutrition.

If you’re experiencing appetite loss, consider eating smaller, more frequent meals throughout the day to make sure you’re getting enough calories and nutrients.

Medical treatment

Stage 3 CKD doesn’t require dialysis or a kidney transplant. Instead, you will be prescribed certain medications to treat underlying medical conditions that may be contributing to kidney damage.

These include angiotensin converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) for high blood pressure, as well as glucose management for diabetes.

Kerendia (finerenone) is a prescription medicine that can reduce the risk of sustained GFR decline, end-stage kidney disease, cardiovascular death, nonfatal myocardial infarction, and hospitalization for heart failure in adults with CKD associated with type 2 diabetes.

Your doctor may also prescribe medications to help alleviate the side effects of CKD, such as:

• iron supplements for anemia
• calcium/vitamin D supplements to prevent bone fractures
• cholesterol-lowering drugs
• diuretics to treat edema

Aside from taking your prescribed medications and eating a healthy diet, adopting other lifestyle changes can help you manage CKD stage 3. Talk to your doctor about the following:

• Exercise. Aim for a minimum of 30 minutes of moderate activity per day on most days of the week. A doctor can help you begin an exercise program safely.
• Blood pressure management. High blood pressure can be a precursor for CKD, and it can make your condition worse. Aim for a blood pressure of 140/90 and below.
• Stress management. Techniques can include exercise, getting better sleep, and meditation.
• Smoking cessation. Talk to a doctor about the right methods of quitting smoking for you.

The goal of CKD stage 3 treatment is to prevent further progression. There’s no cure for any stage of CKD, and you can’t reverse kidney damage.

However, further damage can still be minimized if you’re at stage 3. It’s more difficult to prevent progression in stages 4 and 5.

When diagnosed and managed early, stage 3 CKD has a longer life expectancy than more advanced stages of kidney disease. Estimates can vary based on age and lifestyle.

One such estimate says that the average life expectancy is 24 years in men who are 40, and 28 in women of the same age group.

Aside from overall life expectancy, it’s important to consider your risk of disease progression. One 10-year study of stage 3 CKD patients found that about half progressed to more advanced stages of kidney disease.

It’s also possible to experience complications from CKD, such as cardiovascular disease, which can affect your overall life expectancy.

Stage 3 CKD is often first detected once a person starts experiencing symptoms of this condition.

While stage 3 CKD isn’t curable, an early diagnosis can mean a stop to further progression. It can also mean a decreased risk of complications, such as heart disease, anemia, and bone fractures.

Having stage 3 CKD doesn’t mean your condition will automatically progress to kidney failure. By working with a doctor and staying on top of lifestyle changes, it’s possible to prevent kidney disease from worsening.