Stage 3 Chronic Kidney Disease (CKD)

Diet is an integral part of managing stage 3 CKD. Since kidneys are responsible for filtering out toxins and excess fluid from your body, what you consume impacts how much your kidneys need to work. When your kidneys are damaged, you may need to change your diet.   

For stage 3 CKD, nutritional requirements vary between individuals. It is important to gain advice from a dietitian who can help create a kidney-friendly diet plan that fits your specific needs.   

Generally, a healthy diet for stage 3 CKD patient will involve:

• Increasing high quality protein intake
• Reducing daily sodium intake, calcium consumption and carbohydrates
• Limiting phosphorus, calcium, and potassium intake
• Maintaining water intake of about 1 liter per day

Exercise is key to remaining healthy, and it is no different once you are diagnosed with chronic kidney disease (CKD). Regular exercise can also help manage other conditions, such as high blood pressure and diabetes. At stage 3 CKD, you will be able to exercise normally as before and even start a new exercise routine. You should discuss your exercise routine with your healthcare team and follow the recommendations.   

Monitoring your health is vital at this stage. Your primary care doctor will typically help manage your overall health and monitor conditions such as high blood pressure and diabetes. On the other hand, your nephrologist will see you at regular intervals to assess the progression of your kidney disease.  

Stage 3 CKD cannot be cured or reversed, but its progression can be slowed with treatments such as ACE inhibitors, ARBS and now SGLT2 inhibitors. Often, patients with stage 3 CKD do not progress further and do not require dialysis.  

The diagnosis of CKD can be achieved via a blood test to establish the level of kidney function. A standard test to diagnose the stage of CKD is a blood test that determines the estimated glomerular filtration rate (eGFR), which gives an indication of your kidney function. In stage 3 CKD, the eGFR is between 30 and 59 ml/min.  

Your regular doctor can treat you in the beginning, but as your kidney disease progresses, you will need to be seen by a doctor who specialises in kidney health, also known as a nephrologist. It is very important that you regularly attend an outpatient clinic to be monitored for any progression of CKD and to ensure you receive the right treatments.  

Early diagnosis and management of stage 3 CKD can improve life expectancy. Stage 3 CKD patients can expect to live for decades with drug treatment to delay or halt the progress of the disease.

Sharing your diagnosis with family and friends can be beneficial. To manage your CKD and slow its progression, you will have to make certain lifestyle changes, and it can be helpful if people around you understand your condition.   

Even though CKD progresses from stage 3 to stage 4, the progression does not happen to everyone. The progression of kidney disease depends on multiple factors, including your overall health and how your kidneys respond to treatments and lifestyle changes. It is possible to remain in CKD stage 3 for a long period of time.   

It can be overwhelming when you are first diagnosed with CKD. Talk to your doctor about your concerns. Some questions you may want to ask are:   

• What is my eGFR? This will help you understand whether you are at CKD stage 3a or 3b.  
• What should I expect next?  
• What drugs may reduce kidney damage and slow the progression of CKD?  
• What lifestyle changes do I need to make to slow down the progression of my kidney disease?   
• Do I need a dietitian? Often your doctor can refer you to a renal dietitian who will help you follow a kidney-friendly diet plan.   

Find out important questions to ask when meeting your kidney doctor or nephrologist to make an informed decision about your kidney disease treatment.