Cristian Zanartu, MD, is a licensed board-certified internist who has worked for over five years in pain and palliative medicine.
Stage 3 Chronic Kidney Disease: What to Expect
Cory Martin is the author of seven books including “Love Sick” a memoir about dating, life in Hollywood and dealing with MS. Her essays have appeared online with CNN, HuffPost, Everyday Health, Psychology Today, Folks, The Mighty, and more.
Published on May 03, 2022
Cristian Zanartu, MD, is a licensed board-certified internist who has worked for over five years in pain and palliative medicine.
Table of Contents
Table of Contents
Chronic kidney disease (CKD) occurs when the kidneys are damaged and no longer filter blood the way they should. The kidneys are responsible for removing extra water and waste from the blood to produce urine.
The kidneys also balance salts and minerals, produce hormones that help regulate blood pressure, keep bones strong, and make red blood cells.
In chronic kidney disease, damage to the kidneys happens over a period of time. This damage can occur due to a variety of reasons. People who have high blood pressure, diabetes, heart disease, or a family history of kidney disease are more likely to develop CKD.
Chronic kidney disease is categorized into five stages. An early diagnosis of CKD can help preserve kidney function and slow progression to the later stages.
This article discusses the stages of chronic kidney disease, what having stage 3 means, the symptoms related to stage 3, how to stop progression, and life expectancy.
Stages of Chronic Kidney Disease
There are five stages of chronic kidney disease. In stages 1 through 3, the early stages, the kidneys are still able to filter waste from the blood. In the later stages, stages 4 and 5, the kidneys have to work much harder to eliminate waste and may stop functioning entirely.
Each chronic kidney disease stage is based on estimated glomerular filtration rate (eGFR) test results. The kidneys have small filters known as glomeruli that help remove excess water and waste from the blood.
The eGFR test is a blood test that measures how well the kidneys function. GFR is an estimate of how much volume (of blood) the kidneys are able to successfully filter per minute of time.
This is estimated by measuring particular waste molecules in the bloodstream. The most frequently used one is called creatinine (not to be confused with creatine). The higher the level of creatinine in the blood, the more likely that the kidney’s ability to filter (and therefore function) has become impaired.
Test results determine the stage of CKD. Each stage is associated with an eGFR result as follows:
- Stage 1: eGFR is 90 or higher
- Stage 2: eGFR is 60–89
- Stage 3a: eGFR is 45–59
- Stage 3b: eGFR is 30–44
- Stage 4: eGFR is 15–29
- Stage 5: eGFR is less than 15
Stage 3 Chronic Kidney Disease
Stage 3 chronic kidney disease is considered the middle stage. In stage 3 chronic kidney disease, there is mild to moderate damage to the kidneys, and the kidneys don’t filter waste and fluid as well as they should.
This waste and fluid may build up in the body and cause problems such as high blood pressure. Also, the decrease in viable kidney cells at this stage impairs their role in promoting healthy production of red blood cells, causing anemia, as well as their role in bone metabolism, causing problems in bone structure and metabolism which can lead to fractures.
While damage to the kidneys usually is not reversible, treatment and healthy lifestyle changes can slow the progression. With proper treatment, many people do not progress to stages 4 or 5, which is kidney failure.
Stage 3 Symptoms
While some people do not experience symptoms in stage 3, this stage is often when symptoms first appear. In fact, many people only discover they have chronic kidney disease when they reach stage 3 and experience symptoms.
Symptoms of stage 3 chronic kidney disease include:
- Swelling in the hands and feet
- Fatigue, or feeling weak and tired
- Dry or itchy skin
- Pain in the lower back
- Muscle cramps
- Trouble sleeping
- Urinating more or less often than normal
- Foamy or darker than normal urine
- Restless legs syndrome (RLS), an uncomfortable feeling in the legs that makes it hard to sleep or sit still
Stopping the Progression
Though chronic kidney disease cannot be reversed, there are steps to take to prevent further damage to the kidneys. These steps can improve overall health and may also prevent heart disease.
Even if you are not experiencing symptoms, it’s important to follow your prescribed treatment plan to slow or stop the progression of the disease.
Diet
Making changes to your diet can help you live well with chronic kidney disease. These changes can help manage the disease and prevent further damage to the kidneys.
Dietary changes you can make include:
- Limit sodium: Choose foods with less salt. Buy fresh foods and cook from scratch. Packaged and prepared goods tend to have added sodium. Look for foods labeled “low salt,” “low sodium,” “unsalted,” or “lightly salted.”
- Choose proteins wisely: Protein comes from poultry, meat, eggs, dairy, fish, beans, nuts, and grains. When you consume protein, your body produces waste that must be filtered by the kidneys. Eating more protein than you need can force the kidneys to work harder. Make sure you are eating proper serving sizes. Talk to a dietitian about the right combination of proteins for you.
- Eat heart-healthy foods: Add fruits, vegetables, beans, fish, low-fat dairy, lean meats, and poultry without skin to your diet. Avoid fried foods and opt for grilled or baked options. Limit saturated and trans fats. Cook with nonstick cooking spray or a small amount of olive oil instead of butter.
Lifestyle
Lifestyle changes can improve your overall health and help to slow the progression of kidney disease. These changes include:
- Aiming for a healthy weight.
- Remaining physically active or beginning a physical activity routine.
- Getting enough sleep
- Stopping smoking
- Managing stress
Medical Treatment
Medical management for any stage of CKD will include:
Treating underlying conditions: If the condition causing the decrease in GFR is reversible, efforts should be made to address it. Examples of reversible or treatable conditions that can cause renal failure include:
- Obesity
- Diabetes
- Hypertension
- Heart failure
- Autoimmune kidney disease (e.g., lupus, IgA nephropathy)
- Hepatitis C
- HIV (human immunodeficiency virus)
- Stopping medications or drugs that impair kidney function, including nonsteroidal anti-inflammatory drugs (NSAIDs, such as Advil ibuprofen and Aleve naproxen sodium), some antihypertensives, tobacco, and cocaine
Medications that can help curb the deterioration in kidney function include:
- A group of medications called ACE (angiotensin-converting enzyme) inhibitors or ARBs (angiotensin receptor blockers) can help delay the progression of kidney failure, particularly in people who are shedding protein in their urine.
- Another group of medications called SGLT2 (sodium-glucose cotransporter 2) inhibitors, although primarily labeled as a diabetic medication, can (even without a formal diagnosis of diabetes) protect kidney function.
Treating the complications of kidney failure:
- Although less commonly seen in stage 3 kidney failure, a person will need antihypertensives or diuretics (water pills) to treat water retention due to the decrease in kidney function.
- Anemia from kidney disease is usually treated with medications that stimulate bone marrow production of red blood cells
- Bone changes from kidney disease are usually treated with calcium and vitamin D supplements.
Use Caution with Over-the-Counter (OTC) Medications
Taking NSAIDs for pain relief or cold symptoms can cause damage to the kidneys, especially in people with kidney disease, high blood pressure, and diabetes. Talk to your pharmacist or healthcare provider before starting an OTC medication.
Life Expectancy
Life expectancy with chronic kidney disease depends on the age at diagnosis and how damaged the kidneys are.
Being diagnosed with CKD at an older age is associated with a more near-normal life expectancy. A male diagnosed at the age of 65 in stage 3, for instance, could expect to reach average life expectancy of 76 years old.
Higher rates of eGFR (which means being in the lower stages of CKD) are also associated with a longer life expectancy.
Summary
Stage 3 chronic kidney disease is considered a middle stage of the disease and is often associated with symptoms such as fatigue and fluid retention.
Receiving early treatment, adjusting your diet, and making healthy lifestyle changes such as quitting smoking, can help slow the progression of CKD to the later stages. Though there is no cure for CKD, treatment can help you reach near-normal life expectancy.
A Word From Verywell
Though living with a chronic disease like CKD can feel overwhelming, taking small steps to improve your health over time can give you a sense of control.
Talking to your healthcare provider about lifestyle and dietary changes you can make to protect your kidneys and asking questions when you don’t understand can help you gain a solid treatment plan. Remember to keep all appointments with your healthcare provider and always reach out to them if you feel your symptoms have changed.
Living well with chronic kidney disease may take some effort, but following your treatment plan can help prevent you from progressing into later stages of the disease.
Frequently Asked Questions
What is the life expectancy of someone with stage 3 chronic kidney disease?
It varies. Life expectancy depends on the amount of kidney damage and the age at which you reach stage 3. Older people can expect to reach a near-normal life expectancy, while younger people with more kidney damage can expect a significantly lower life expectancy.
How long does it take to go from stage 3 to stage 4 of chronic kidney disease?
Some people will never progress to stage 4, however, one study found that about 50% will move to stage 4 over the course of 10 years.
Is chronic kidney disease curable?
Chronic kidney disease is not curable, however, there are treatment options and lifestyle changes you can make to slow or stop the progression of the disease.
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
- National Institute of Diabetes and Digestive and Kidney Diseases. What is chronic kidney disease?
- MedlinePlus. Glomerular filtration rate.
- American Kidney Fund. Stages of kidney disease.
- American Kidney Fund. Stage 3 chronic kidney disease.
- National Institute of Diabetes and Digestive and Kidney Diseases. Managing chronic kidney disease.
- National Institute of Diabetes and Digestive and Kidney Diseases. Eating right for chronic kidney disease.
- Centers for Disease Control and Prevention. National vital statistics report.
- Neild GH. Life expectancy with chronic kidney disease: an educational review. Pediatr Nephrol. 2017;32(2):243-248. doi:10.1007/s00467-016-3383-8
- Turin TC, Tonelli M, Manns BJ, Ravani P, Ahmed SB, Hemmelgarn BR. Chronic kidney disease and life expectancy. Nephrol Dial Transplant. 2012;27(8):3182-6. doi:10.1093/ndt/gfs052
- Baek SD, Baek CH, Kim JS, Kim SM, Kim JH, Kim SB. Does stage III chronic kidney disease always progress to end-stage renal disease? A ten-year follow-up study. Scand J Urol Nephrol. 2012;46(3):232-238. doi:10.3109/00365599.2011.649045
Chronic Kidney Disease Life Expectancy: Outlook and More
Cory Martin is the author of seven books including “Love Sick” a memoir about dating, life in Hollywood and dealing with MS. Her essays have appeared online with CNN, HuffPost, Everyday Health, Psychology Today, Folks, The Mighty, and more.
Published on April 15, 2022
Anju Goel, MD, MPH, is a board-certified physician who specializes in public health, communicable disease, diabetes, and health policy.
Table of Contents
Table of Contents
Chronic kidney disease (CKD) occurs when the kidneys become damaged and can no longer adequately filter blood. The kidneys are responsible for filtering extra water and waste out of the blood to produce urine. When the kidneys don’t function properly, waste can build up in the body, causing various symptoms and problems.
Kidney disease can worsen over time and lead to kidney failure. Early diagnosis can help prevent further damage to the kidneys.
Chronic kidney disease is a slow, progressive disease diagnosed in stages. Stages 1 and 2 indicate mild damage to the kidneys, while stages 3, 4, and 5 reflect more serious progression that affects prognosis and life expectancy.
In this article, you will learn more about stages 3, 4, and 5 of CKD, life expectancy at each stage, and how to cope with the disease.
Chronic Kidney Disease Stages
The stages of chronic kidney disease range from mild to severe. In the early stages (1 and 2), damage to the kidneys is mild. The kidneys still work fairly well, and symptoms may not occur. The only indication of kidney damage may be in certain blood or urine tests.
The later stages of CKD occur when damage to the kidneys becomes more apparent. Symptoms often appear in these stages.
Stage 3 Kidney Disease
Stage 3 kidney disease is separated into two sub-stages: stage 3a and stage 3b. These substages are based on an eGFR blood test which measures how well the kidneys filter waste.
An eGFR between 45 and 59 indicates stage 3a. Kidney damage in this stage is mild to moderate. Symptoms such as swelling in the hands and feet and feeling weak and tired may appear.
An eGFR between 30 and 44 indicates stage 3b. Kidney damage is moderate to severe, and symptoms may progress. Other health problems such as high blood pressure and bone disease can also occur.
In one study, about half of people with stage 3 did not progress to stage 4 or 5. Treatment and healthy lifestyle changes to protect the kidneys can slow the progression of CKD.
Stage 4 Kidney Disease
Stage 4 indicates severe kidney damage with an eGFR of 15-29. Symptoms can include swelling in the arms and legs, muscle cramps, nausea, vomiting, and loss of appetite.
Other health problems can develop because of the buildup of waste in the body. These include:
- Anemia (when there are not enough healthy red blood cells in the blood)
- Heart disease
- Metabolic acidosis (a condition where there is too much acid in the body)
- High blood pressure
Stage 4 is the last stage before kidney failure. Treatment includes blood pressure and diabetes medicines, diuretics (water pills), iron supplements to help with anemia, and supplements like calcium and vitamin D.
In some cases, dialysis, a treatment to help the body filter the blood, may become necessary.
Stage 5 Kidney Disease/End-Stage Renal Disease
Stage 5, also known as end-stage renal disease, is indicated by an eGFR of less than 15. Damage to the kidneys is severe. The kidneys have failed. The symptoms and concurrent health issues such as high blood pressure and anemia from stage 4 can all occur in stage 5 as well.
In this stage, you will need to see a nephrologist, or kidney doctor, to develop a treatment plan and monitor your kidney health.
Treatment options in this stage include dialysis or kidney transplant, along with blood pressure medications, diabetes medications, and other medications to treat symptoms.
Chronic Kidney Disease Life Expectancy by Stage
Life expectancy with CKD depends on the person’s age and the stage at which diagnosis occurs. Having more kidney damage at an earlier age can reduce life expectancy more than being diagnosed later in life with less kidney damage.
Stage 3 Kidney Disease Life Expectancy
Life expectancy for stage 3 kidney disease is dependent on the age of diagnosis. One study found that the life expectancy for men and women diagnosed with stage 3a at the age of 40 was a little under 12 years less than the average U.S. life expectancy.
On the other hand, the same study found that being diagnosed with stage 3a at age 60 resulted in about a six-year decrease in life expectancy compared to average U.S. life expectancy.
Stage 4 Kidney Disease Life Expectancy
Stage 4 kidney disease is associated with greater damage to the kidneys. At this stage, the disease has progressed quite far.
The life expectancy for someone diagnosed with stage 4 at any age is significantly lower than the average life expectancy. One study found that the life expectancy for someone age 70 who enters stage 4 kidney disease is about four years.
As with any such figures, there are many factors, such as newer treatments, that might not be reflected in past studies.
Stage 5 Kidney Disease/ESRD Life Expectancy
Stage 5 kidney disease, or end-stage renal disease, carries a much lower life expectancy than all other stages. At this stage, the kidneys have failed.
The damage to the kidneys cannot be undone. While dialysis and kidney transplant are options in this stage that can prolong life, life expectancy is fairly low.
Coping With Chronic Kidney Disease
Living well with chronic kidney disease is possible. Knowing the signs and symptoms, understanding the causes, seeking early diagnosis, and following a treatment plan can all help you live a longer, healthier life with CKD.
Signs and Symptoms of CKD
The early stages of CKD may not have symptoms. Though there may be damage to the kidneys the damage is not enough to cause symptoms. As CKD progresses, symptoms develop.
Symptoms include but aren’t limited to:
- Swelling in the legs, feet, and ankles.
- Skin that is dry, itchy, or numb
- Fatigue
- Headaches
- Urinating more or less
- Nausea
- Lack of appetite
- Sleep problems
- Vomiting
- Weight loss
Causes of Chronic Kidney Disease
Diabetes and high blood pressure are the two most common causes of chronic kidney disease. In diabetes, high blood sugar can damage the filters in the kidneys, making them unable to function the way they should.
High blood pressure can cause damage to the blood vessels in the kidneys and affect their ability to function.
Other causes of CKD include:
- Diseases that affect the entire body, such as lupus (an autoimmune inflammatory disease)
- Genetic disorders, like polycystic kidney disease (in which there are multiple cysts in the kidneys)
- An infection
- Drugs that are toxic to the kidneys
- IgA glomerulonephritis (a buildup of an immune system protein in the filters of the kidney)
- Heavy metal poisoning
- Renal artery sclerosis (narrowing of one of the arteries that supply the kidney)
Diagnosing Chronic Kidney Disease
Diagnosis of chronic kidney disease is important because the earlier the diagnosis the earlier treatment can begin to help protect the kidneys.
Those at higher risk for developing chronic kidney disease should talk to their healthcare provider about when to test for kidney disease. Having diabetes, high blood pressure, heart disease, or a family history of kidney failure can all put you at a higher risk for developing kidney disease.
Early chronic kidney disease often does not have symptoms. Diagnosing the disease requires medical tests. These tests include the eGFR blood test to check kidney function and urine tests that check for protein.
Management and Treatment of Chronic Kidney Disease
The goal of treating and managing chronic kidney disease is to limit or prevent further damage to the kidneys. Preventing further damage to the kidneys can slow progression to later stages of CKD which in turn can improve life expectancy.
Steps taken to manage CKD can also improve overall health. These include:
- Controlling blood pressure
- Managing blood sugar levels if you have diabetes
- Taking medications as prescribed
- Working with a dietitian to devise an eating plan that will support and protect the kidneys
- Exercising
- Getting enough sleep
- Stopping smoking
- Reducing stress
Dialysis and kidney transplant are used to treat end-stage kidney disease. Dialysis allows people with end-stage kidney disease to prolong life by years or even decades. Dialysis is also an option for those who are waiting for a kidney transplant.
A kidney transplant is one of the best options for end-stage renal disease. Long-term survival and quality of life increase with a transplant. However, a transplant does carry risks in the short term due to the possibility of infection and organ rejection.
Summary
Life expectancy with chronic kidney disease depends on the age at which you enter each stage. There are five stages of CKD, with stages 3, 4, and 5 being the most severe.
Seeking early diagnosis and treatment for CKD can improve life expectancy. Treatment options are available. Dialysis and kidney transplant can lead to a longer and better quality of life.
A Word From Verywell
A diagnosis of chronic kidney disease can be scary and make you wonder about life expectancy. Taking a proactive approach to managing your health can help give you a sense of control and peace of mind.
Regularly working with your healthcare provider to develop a treatment plan to protect your kidneys from further damage and prevent other complications can help prolong life.
Frequently Asked Questions
How does chronic kidney disease affect my life expectancy?
Chronic kidney disease’s effect on life expectancy depends on the amount of damage to the kidneys. However, it decreases life expectancy at every age and stage. Preventing further damage to the kidneys as well as preventing other conditions (such as heart disease) are critical to having the best life expectancy.
Is chronic kidney disease terminal?
Chronic kidney disease can progress to end-stage renal disease, which is terminal without ongoing dialysis or a kidney transplant. However, progression is not inevitable.
Can you live a long life with chronic kidney disease?
With proper treatment and healthy lifestyle changes, it is possible to live a long life with CKD.
Can chronic kidney disease be cured?
Chronic kidney disease cannot be cured. Damage to the kidneys is permanent which is why preventing further damage is important.
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
- National Institute of Diabetes and Digestive and Kidney Diseases. What is chronic kidney disease?
- American Kidney Fund. Stages of kidney disease.
- MedlinePlus. Glomerular filtration rate (Gfr) test.
- Baek SD, Baek CH, Kim JS, Kim SM, Kim JH, Kim SB. Does stage III chronic kidney disease always progress to end-stage renal disease? A ten-year follow-up study.Scand J Urol Nephrol. 2012;46(3):232-238. doi:10.3109/00365599.2011.649045
- National Institute of Diabetes and Digestive and Kidney Diseases. Managing chronic kidney disease.
- American Kidney Fund. Stage 4 chronic kidney disease (CKD).
- American Kidney Fund. Stage 5 chronic kidney disease (CKD).
- Neild GH. Life expectancy with chronic kidney disease: an educational review. Pediatr Nephrol. 2017;32(2):243-248. doi:10.1007/s00467-016-3383-8
- Reindl-Schwaighofer R, Kainz A, Kammer M, Dumfarth A, Oberbauer R. Survival analysis of conservative vs. dialysis treatment of elderly patients with CKD stage 5. PLoS One. 2017;12(7):e0181345. doi:10.1371/journal.pone.0181345
- National Institute of Diabetes and Digestive and Kidney Diseases. Causes of chronic kidney disease.
- National Institute of Diabetes and Digestive and Kidney Diseases. Chronic kidney disease tests & diagnosis.
- InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG). Dialysis in chronic kidney disease.
- Kaballo MA, Canney M, O’Kelly P, Williams Y, O’Seaghdha CM, Conlon PJ. A comparative analysis of survival of patients on dialysis and after kidney transplantation. Clin Kidney J. 2018;11(3):389-393. doi:10.1093/ckj/sfx117
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