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    Stage 3 of Chronic Kidney Disease

    Reviewed by Medical Contributor Dinesh K. Chatoth, MD, FASN on September 9, 2025.
    Stage 3

    What is stage 3 kidney disease?

    Many people with chronic kidney disease (CKD) are diagnosed in stage 3. At this stage, your kidney function is beginning to decline and needs to be monitored. You may even start to experience some symptoms. In late stage 3, you could be experiencing a loss of 65% or more of your kidney function, impacting your overall health. There are steps and changes you can make to help prevent CKD from progressing further so you can continue to live a long, healthy life.

    Stage 3 CKD happens when your estimated glomerular filtration rate (eGFR) falls between 30-59, showing moderate loss of kidney function. Stage 3 has two phases—stage 3a and 3b. You can learn how to protect your kidney health by learning more about how to manage stage 3 CKD.

    What is the difference between stages 3a and 3b kidney disease?

    Stage 3 kidney disease has two levels based on how well your kidneys are filtering waste and toxins from your blood, which is measured by your eGFR.

    Stage 3a is CKD with an eGFR of 45-59

    In stage 3a, you have mild to moderate loss of kidney function. At this stage, most people don’t notice any symptoms, and simple lifestyle changes can go a long way to help manage the progression of CKD.

    Stage 3b is CKD with an eGFR of 30-44

    At stage 3b, you have moderate to severe loss of kidney function. You may start to notice symptoms at this stage and it’s important to discuss these changes with your doctor. Making healthy lifestyle changes still plays an important role in preventing further progression of CKD.

    Are stage 3a and 3b CKD managed differently?

    While stages 3a and 3b have different levels of kidney function, the steps you should take to manage CKD are the same. In both phases, your goal is to prevent any further loss of kidney function. It’s important to see your doctor regularly. Discuss any changes in your lab values or symptoms you may be experiencing. It’s also a great time to find a kidney doctor (nephrologist) to help you manage kidney disease.

    Symptoms of stage 3 kidney disease

    Many people do not experience symptoms of kidney disease disease until later stages when kidney function is much lower. Understanding the symptoms that may occur can help you recognize the signs that your kidneys are not properly functioning. Talk to your nephrologist (kidney doctor) if you experience any of the following symptoms, or if you notice changes in existing symptoms:

    If you’re experiencing any of the symptoms listed above and have an eGFR of 30-44, talk to your doctor about seeing a kidney doctor (nephrologist). A nephrologist is specially trained in treating kidney disease and the most qualified doctor to help you manage your kidney health.

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    How do I slow the progression of stage 3 kidney disease?

    In stage 3, you have the opportunity to take control over your long-term health. While there is no cure for CKD, lifestyle changes like eating a balanced diet, taking medications as prescribed, and staying active can make a big impact on your well-being and kidney health.

    How to manage stage 3 kidney disease


    1. Make healthy lifestyle choices—Eating a kidney-friendly diet, quitting smoking, exercising, and maintaining a healthy weight can help you slow progression at stage 3 kidney disease.
    2. Monitor your health—Managing underlying conditions and risk factors such as high blood pressure, diabetes, and/or infection can also help slow the progression of CKD. There are also medications like SGLT-2 inhibitors or GLP-1 antagonists that may help you slow the progression of kidney disease. Talk to your doctor about whether you need to start, stop, or modify any of the vitamins, supplements, or medications you may be taking, including those for other health conditions (such as ACE inhibitors or ARBs).
    3. Talk to your doctor about a referral to see a kidney doctor when you reach Stage 3b or start experiencing symptoms—If you haven’t already received a referral to see a kidney doctor (also known as a nephrologist), talk to your doctor about a referral to see one. A nephrologist is most qualified to help you manage your kidney health and will work with you and your doctor to develop a Care Plan.
    4. Meet with a renal dietitian—Following a kidney-friendly diet is key to slowing the progression of CKD, and you don’t have to do it alone. A renal dietitian can help you address any nutrition concerns and will teach you about eating well with kidney disease.
    5. Learn everything you can about CKD—Taking our free kidney class online can help you learn more about how to manage and slow the progression of CKD. Our free class covers the basics of living with CKD, from tips for kidney-friendly eating to information about possible treatment options.
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    Why you need a kidney doctor
    A nephrologist, also known as a kidney doctor, is the most qualified doctor to help you manage kidney disease. Ask your doctor for a referral to a nephrologist when your eGFR is between 30-44.
    Learn More

    What to eat with stage 3 kidney disease to feel your best

    Eating the right foods can help lower stress on your kidneys, support other conditions like hypertension and diabetes, and help slow the progress of kidney disease. Here’s what you should keep in mind:

    Consider working with a renal dietitian to understand what healthy eating looks like for you. While there are general best dietary practices for stage 3 CKD, a dietitian provides personalized guidelines based on your needs. They will make a specific plan for you based on factors like your eGFR and any existing health conditions or medications you take.

    Eating the right amount of protein is important. Too much can strain the kidneys, while too little can impact nourishment your body needs. While protein is an important part of your diet, it creates waste called urea. With CKD, your kidneys may not be able to remove the urea, which can make you tired or lose your appetite. Your doctor may recommend limiting your protein intake. Eat smaller portions, limit processed foods, and choose leaner proteins to balance intake. Healthy sources of protein include lean meats, poultry, fish, eggs, beans, lentils, and small portions of nuts and seeds.

    Eating less sodium can help manage blood pressure, reduce fluid retention, and support long-term kidney health. Talk to your doctor or dietitian about how much daily sodium is right for you. You can read food labels to keep track of your sodium intake and avoid high-sodium foods like salty snacks, processed items, and canned soups. Instead, choose fresh foods and ingredients, and cook more meals at home. You can add more herbs and spices to reduce sodium levels without losing flavor.

    Be aware of how much potassium is in your diet. Potassium is an important mineral that helps regulate your heart rhythm. When you have CKD, your kidneys struggle to balance potassium levels. If potassium levels get too high, it can cause an irregular heartbeat and increase the risk of a heart attack. Generally, people with CKD should limit potassium intake to about 2,000 milligrams per day. Ask your doctor or dietitian to find out how much potassium is right for you. Avoid high-potassium foods like bananas, oranges, potatoes, and tomatoes. Go for low-potassium options like berries, melons, pineapple, green beans, squash, or bell peppers, and limit portion sizes.

    People with CKD should generally consume no more than 800 to 1,000 milligrams of phosphorus per day. Too much phosphorus can lead to bone disease and other complications. Foods and drinks with chemically added phosphorus absorb more than naturally occurring phosphorus. Avoid foods that contain “PHOS” on the label and limit portion sizes to reduce phosphorus in your diet.

    Balancing your fluid intake is an important step to take to slow the progression of CKD. Too much fluid can overwhelm your kidneys, and too little can lead to dehydration. Track all fluids you consume to keep tabs on your fluid intake. Keep in mind that foods that melt or are liquid at room temperature are considered fluids. Recommended fluid intake varies from person to person. You should talk to your doctor or renal dietitian about how much fluid your body needs.

    Meal planning can make following a kidney-friendly diet easier. Use our meal planning tips to build your own kidney disease meal plan. Focusing on portion control and balanced meals will help you stay on track. You can visit our library of delicious kidney-friendly recipes for inspiration. We have recipes for every meal of the day, from zesty orange tilapia for dinner to zucchini sauté for a light and delicious snack.

    Questions to ask your doctor about stage 3 kidney disease

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    Remember that you are an active partner in your kidney health journey. Asking your doctor questions will help you make informed decisions about your treatment and take control of your health.

    Understanding my condition


    Monitoring and testing

    • How often should I get labs or follow-ups?
    • Should I be seeing a nephrologist now?

    Diet and lifestyle

    • Should I follow a kidney-friendly (renal) diet? Can I talk to a renal dietitian?
    • Should I limit salt, protein, potassium, or phosphorus?
    • How much water or fluid should I drink per day?
    • Is it okay to exercise—and if so, what kind?

    Medications

    • Are there any medications I should avoid (like ibuprofen or antacids)?
    • Should I be on an ACE inhibitor or ARB to protect my kidneys?
    • Are there supplements I need (like vitamin D or iron)?

    Other health concerns


    Future planning

    • What can I do to protect my kidney function for as long as possible?
    • If my kidney function declines, what are the next steps?
    • Is dialysis or kidney transplant a possibility in the future?
    • Am I doing everything I can to slow my progression?

    Frequently asked questions about stage 3 kidney disease

    Many people with stage 3 CKD never progress to stage 4 or 5. While there is no cure and loss of kidney function cannot be reversed, it is possible to slow or prevent further progression. With healthy lifestyle adjustments, you can slow progression and live a healthy, full life.

    Think of stage 3 CKD as the “middle stage” of kidney disease. You don’t need dialysis or a kidney transplant because your kidneys are still functioning. With treatment and healthy lifestyle adjustments, you may never need dialysis. It is important to work with your doctor and a nephrologist to monitor your kidney health and preserve your remaining kidney function.

    For stage 3 CKD, annual checkups are important. Your doctor will evaluate how well your kidneys are working. If you start to experience symptoms or are at stage 3b and haven’t seen a nephrologist, ask your doctor for a referral to see one.

    When you’re living with kidney disease, it is important to understand how medications may impact your kidney health. Some over-the-counter (OTC) medications are safe to use while others are not recommended. This list explains which common OTC medications are safe to use and which medications you should limit or avoid taking. Bring a list of your medications to review with your doctor at your next appointment.

    Learn more about kidney disease stages

    Get details on CKD stage 4
    Stay feeling your best with kidney disease
    Our free education class will give you tips and tools to manage your kidney health. Learn about eating well and treatment options like home dialysis and transplant.
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