🧬 Your Kidney Function Results – Stage 3 CKD

Moderate reduction in kidney function (eGFR 30‑59 mL/min). Medical intervention and lifestyle changes are essential to slow progression.

⚠️ Moderate urgency – see a nephrologist within 3 months.

📊 Estimated Glomerular Filtration Rate (eGFR)

0 mL/min Stage 3 – Moderate CKD (30‑59)

Medical description: At this stage, the kidneys have lost 40‑70% of their filtering capacity. Complications such as anaemia, bone disease, and metabolic acidosis may begin to appear. However, with aggressive management, many people never progress to stage 4 or 5.

✅ Action is critical – slowing progression is still very achievable.

⚠️ Risk Factors Identified

Total modifiable risk factors: 0 (each one controlled can add years of kidney health).

✅ Age not a major risk factor – focus on other modifiable factors.

✅ Healthy BMI range – maintain with balanced nutrition.

🧪 Urine Protein – Key Prognostic Marker

✅ No protein detected in urine – but still monitor annually.

🍬 Glucose in Urine & Diabetes Control

✅ No glucose in urine – continue routine diabetes screening if at risk.

📋 Medical Management & Lifestyle Advice (Stage 3)

Blood pressure target: < 130/80 mmHg. First‑line drugs: ACE inhibitors or ARBs (also reduce proteinuria).
Diabetes control: HbA1c ≤ 7.0% (individualised to avoid hypoglycaemia). SGLT2 inhibitors or GLP‑1 agonists offer kidney protection.
Dietary modifications:
- Restrict sodium to < 2g/day (avoid processed foods, canned soups, salty snacks).
- Limit protein intake to 0.6‑0.8 g/kg ideal body weight (consult a renal dietitian).
- Control potassium and phosphorus if blood levels become elevated – avoid oranges, bananas, potatoes, dairy, nuts if hyperkalaemia or hyperphosphataemia develops.
Monitor complications:
- Haemoglobin (anaemia) – if Hb < 11 g/dL, consider iron and/or erythropoiesis‑stimulating agents.
- Calcium, phosphate, PTH (bone metabolism) – start vitamin D analogues if needed.
- Bicarbonate (metabolic acidosis) – oral sodium bicarbonate may slow progression.
Avoid nephrotoxic drugs: NSAIDs, high‑dose proton pump inhibitors, aminoglycosides, IV contrast (use preventive measures if essential).
Vaccination: Influenza, COVID‑19, pneumococcal, hepatitis B (if not immunised).
Follow‑up: Nephrology referral if GFR < 45 or rapid decline (drop >5 mL/min/year). Recheck eGFR, urine protein, and electrolytes every 3‑6 months.

⚠️ When eGFR may be misleading

The calculated GFR can be inaccurate in certain situations:

Acute kidney injury – recheck after stabilisation
Very low muscle mass (amputation, malnutrition, elderly) – consider cystatin C based eGFR
High muscle mass (bodybuilders)
Vegetarian diet (lower creatinine production)
Drugs that block creatinine secretion (cimetidine, trimethoprim)
Pregnancy
Severe liver disease

Clinical note: Stage 3 CKD is often asymptomatic. Up to half of people over 70 have stage 3A (eGFR 45‑59) without progression – but any proteinuria or rapid decline requires aggressive management.

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