What Is Stage 3 Ckd
In Stage 3 CKD, your kidneys have mild to moderate damage, and they are less able to filter waste and fluid out of your blood. This waste can build up in your body and begin to harm other areas, such as to cause high blood pressure, anemia and problems with your bones. This buildup of waste is called uremia.
Stage 3 CKD is split into 2 sub-stages based on your eGFR:
Stage 3a means you have an eGFR between 45 and 59, and Stage 3b means you have an eGFR between 30 and 44.
Stage 2 Kidney Disease Life Expectancy
People at stage 2 kidney disease are still considered to have overall healthy kidney function. Thus the prognosis is much better compared to more advanced stages of CKD.
The goal then is to prevent further progression. As CKD gets worse, it can also cause potentially life threatening complications, such as heart disease.
What Are The Ckd Stages
Your kidneys keep a healthy balance between water, salts, and minerals like sodium, calcium, and potassium. They also make hormones that control your blood pressure, keep your bones strong, and help make red blood cells.
Your kidneys also filter extra fluid and waste from your body through units called nephrons. Each nephron has a glomerulus, which filters your blood, and a tubule, which removes the waste and returns what you need back to your blood.
Your kidneysâ filtering speed is called the glomerular filtration rate . If your kidneys are damaged, this GFR will be lower. Blood tests show your estimated glomerular filtration rate and different stages of damage.
The CKD stages are as follows:
- Stage 1 CKD, mild kidney damage with an eGFR above 90 milliliters or greater per minute
- Stage 2, mild damage with 60 to 89 milliliters per minute
- Stage 3a, moderate damage with 45 to 59 milliliters per minute
- Stage 3b, moderate damage with 30 to 44 milliliters per minute
- Stage 4, severe damage with 15 to 29 milliliters per minute
- Stage 5, kidney failure with less than 15 milliliters per minute, a level at which the kidneys are no longer working
Stage 5 CKD is also called end-stage renal disease. At this stage, you will need dialysis or a kidney transplant. Not everyone has CKD that worsens, though.
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Stages Of Chronic Kidney Disease
About chronic kidney disease
With chronic kidney disease, the kidneys dont usually fail all at once. Instead, kidney disease often progresses slowly years. If caught early, medicines and lifestyle changes may help slow or prevent CKD progression.
Five stages of chronic kidney disease
The National Kidney Foundation divided kidney disease into five stages. This helps doctors provide the best care, as each stage calls for different tests and treatments.
Doctors determine the stage of kidney disease using the glomerular filtration rate , a math formula using a person’s age, gender, and their serum creatinine level . Creatinine, a waste product that comes from muscle activity, is a key indicator of kidney function. When kidneys are working well they remove creatinine from the blood but as kidney function slows, blood levels of creatinine rise.
Use the links below to learn about each stage of kidney disease:
How Are Kidney Disease Stages Measured
Kidney disease progresses at different rates for different people, and it can take between two and five years to pass between different CKD stages.
Kidney disease stages are measured by using a blood test to check the estimated glomerular filtration rate . This shows the amount of blood that is getting filtered through the kidneys every 60 seconds. As kidney function decreases, GFR drops, so a lower GFR indicates a more advanced stage of CKD.
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Treatment For Stage 5 Ckd
Stage 5 is defined as end-stage renal disease, at which point your child needs to go on dialysis or have a kidney transplant. Both are effective treatments, and our goal is to transplant virtually all of our patients with ESRD. Around 75 percent of children with ESRD go on dialysis before receiving a transplant.
One of the roles of your child’s kidneys is to act as a filter for their blood, making sure that it has the right balance of water and minerals. If your child’s kidneys are unable to do this, dialysis is a procedure that can do it for them. Dialysis may be given every night at home, or at a hospital or dialysis center three or four times a week.
In some children, including those with the severe form of FSGS or familial hemolytic uremic syndrome , the disease causes the kidney to fail almost as soon as it is transplanted. In other cases, it may not be a good time for the family to have the child undergo a transplant. The good news is that a kidney transplant is very rarely an emergency, and never absolutely necessary, because dialysis is such an effective treatment.
What Can I Expect If I Have Kidney Disease
If you have kidney disease you can still live a productive home and work life and enjoy time with your family and friends. To have the best outcome possible, its important for you to become an active member of your treatment team.
Early detection and appropriate treatment are important in slowing the disease process, with the goal of preventing or delaying kidney failure. You will need to keep your medical appointments, take your medications as prescribed, stick to a healthy diet and monitor your blood pressure and blood sugar.
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What To Expect With Stage 3 Kidney Disease
As stated earlier, stage 3 kidney disease does not often statistically lead to stage 4 kidney disease. However, it also does predispose someone to mortality more than not having any kidney disease at all.
âIf you have stage 3 kidney disease, you shouldnât expect to feel many severe symptoms. It should be a time to reevaluate your habits, make treatment plans with your doctor or doctors, and focus on staying healthy. The most important elements to preventing kidney failure are keeping medical appointments, taking your medications, having a healthy lifestyle, and monitoring your blood pressure and blood sugar.
Stage : Gfr < 15ml/min Kidney Failure
End stage renal disease is the final stage of chronic kidney disease , also known as kidney failure. This occurs when the kidneys function below 10-15 percent and is often a result of years of chronic kidney disease. After being diagnosed with ESRD, it is important to decide what treatment option you will use, such as home dialysis, incenter hemodialysis, transplantation, or palliative care.
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How Do Doctors Treat Stage 4 Ckd
You will need to see a nephrologist . Your nephrologist will treat Stage 4 CKD with medicines that help with your symptoms and other health problems that kidney disease can cause, such as diabetes and high blood pressure.
These medicines include:
- Blood pressure medicines like ACE inhibitors and ARBs
- Diabetes medicines to keep your blood sugar at a healthy level
- Calcium and vitamin D supplements to keep your bones strong
- Diuretics to help with swelling
- Erythropoiesis-stimulating agents or iron supplements to help with anemia
Your doctor may tell you to stop taking medicines that can damage your kidneys, such as pain medicines called NSAIDs .
Your nephrologist will decide if your kidneys are close to failure and if you need to start treatment. If you need treatment, they will talk with you about your choices, which include:
- Dialysis, which is a treatment to clean your blood when your kidneys are not able to. Learn more about the 2 types of dialysis.
- A kidney transplant, which is surgery to give you a kidney from someone else’s body. Learn more about kidney transplants.
There is usually no cure for CKD, and you usually cannot reverse the kidney damage you already have by the time you get to stage 4 CKD. However, you can take steps to slow down the damage to your kidneys and help you feel your best.
How Can I Tell If My Kidneys Have Failed
End-stage renal disease is when normal kidney function declines and needs to be replaced by dialysis or transplant. This is also known as kidney failure. At this point, GFR is at 10 or less, and kidneys can no longer balance electrolytes and acids in the blood or remove wastes and excess water.
Symptoms that some people experience during this time could include:
- Metallic taste in the mouth
- Mild to moderate depression
It is important to keep your doctor informed of your symptoms so she/he can help you decide when its time to start dialysis or be evaluated for transplant.
Blood tests will show that your blood urea nitrogen and creatinine are not being properly eliminated by the kidneys and are building up in the blood. These tests may also show that your electrolytes and pH are out of balance.
Generally, planning for kidney replacement therapy is done when your kidney function is at about 25 percent. If you wait until you are very sick, it will take you much longer to recover and may require hospitalizations.
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Control Other Health Problems
You may have other disorders, such as diabetes and high blood pressure, which can damage your kidneys. One of the goals of your treatment is to make sure these are well-controlled. Ask your healthcare professional what you can do to keep these conditions under control – and do it! Some of the things your healthcare professional may ask you to do:
- Take medications called angiotensin converting enzyme inhibitors or angiotensin receptor blockers as part of your therapy. Studies have shown that these medications help to protect your kidney function. You may also need other blood pressure medications to control your blood pressure.
- Lose weight if you are overweight
- Cut down on salt in your diet to control blood pressure
- If you have diabetes, monitor your blood sugar, follow your diet and take your medications as prescribed
Stage 3 Kidney Disease Life Expectancy
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, its 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.
Its also possible to experience complications from CKD, such as cardiovascular disease, which can affect your overall life expectancy.
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What Is Stage 4 Kidney Disease
Chronic kidney disease happens if your kidneys have been damaged. Kidneys can become damaged from a physical injury or a disease like diabetes or high blood pressure. Once your kidneys are damaged, they are not able to filter blood or do their other jobs well enough to keep you healthy. Some of the important jobs kidneys do:
- Filter blood
- Help keep blood pressure under control
- Keep bones healthy
- Help make red blood cells
There are five stages of chronic kidney disease. The mildest are stages 1 and 2. In these early stages of kidney disease, the kidneys are damaged and not working at full strength. At stage 3, about half of kidney function has been lost. This can cause other problems, like high blood pressure or bone problems. Treatment of these problems is very important, and it can even help slow down the loss of kidney function. At stage 4, severe kidney damage has happened. At this stage, it is very important to slow the loss of kidney function by following your treatment plan, and managing other problems like high blood pressure or heart disease. Stage 5 is kidney failure. If kidney failure happens, you will need a kidney transplant or dialysis to live.
Who Should Be Tested For Ckd
See your GP if you have persistent symptoms of CKD, such as:
- weight loss or poor appetite
- swollen ankles, feet or hands
- peeing more than usual, particularly at night
Your GP can look for other possible causes and arrange tests if necessary.
Because CKD often has no symptoms in the early stages, some people at a higher risk should be tested regularly.
Regular testing is recommended if you have:
- acute kidney injury sudden damage to the kidneys that causes them to stop working properly
- cardiovascular disease conditions that affect the heart, arteries and veins, such as coronary heart disease or heart failure
- other conditions that can affect the kidneys such as kidney stones, an enlarged prostate or lupus
- a family history of advanced CKD or an inherited kidney disease
- protein or blood in your urine where there’s no known cause
You’re also more likely to develop kidney disease if you’re black or of south Asian origin.
People taking long-term medicines that can affect the kidneys, such as lithium, omeprazole or non-steroidal anti-inflammatory drugs , should also be tested regularly.
Talk to your GP if you think you may need regular testing for kidney disease.
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Whats The Prognosis For Stage 4 Kidney Disease
Theres no cure for stage 4 chronic kidney disease. The goal of treatment is to prevent kidney failure and maintain a good quality of life.
In 2012, researchers found that men and women with low kidney function, especially less than 30 percent, had substantially reduced life expectancy.
They noted that women tend to have longer life expectancy in all stages of kidney disease except stage 4, where theres only a slight difference by gender. Prognosis tends to be poorer with age.
- At 40 years old, life expectancy is about 10.4 years for men and 9.1 years for women.
- At 60 years old, life expectancy is about 5.6 years for men and 6.2 years for women.
- At 80 years old, life expectancy is about 2.5 years for men and 3.1 years for women.
Your individual prognosis also depends on co-existing conditions and what treatments you get. Your healthcare provider can give you a better idea of what to expect.
Do What You Can To Manage The Complications Of Kidney Disease
Kidney disease can cause other health problems throughout your body including:
- Heart and blood vessel problems
- Mineral and bone problems
- High blood pressure
- Poor nutritional health
If you have stage 4 kidney disease, you are probably experiencing some of these problems already. Your healthcare professional will work with you to develop a treatment plan to help manage these problems and keep them from getting worse. Treatment may include diet, exercise, and medications. It is very important that you follow your treatment plan because it can greatly improve your quality of life and how long you live. It can also help to slow or even stop kidney disease from getting worse – and it may even stop or delay kidney failure.
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Public Forumdissecting And Refining The Staging Of Chronic Kidney Disease
The current Kidney Disease Outcomes Quality Initiative staging system of chronic kidney disease is simple but too rigid to accommodate variations in renal function observed in the general population. The formula most commonly used to estimate renal function is not validated in subjects without a priori evidence of renal disease. Their combined use results in inappropriate diagnosis of CKD and improbable estimates of prevalence rates. Although this initiative has raised the profile of kidney disease, the exaggeration of the scope of the problem could distract nephrologists from their specialist role. The nephrology community needs a revised staging system for CKD that allows accurate, effective, and timely communication with patients, primary care doctors, public health physicians, and policy makers. Its single most important function will be to identify those patients who will benefit from targeted screening and effective and safe interventions. We offer for discussion a modified definition and staging system of CKD based on the presence of unequivocal, irreversible structural kidney disease, the presence or degree of impairment of kidney function, and the consequences thereof.
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What Are The Symptoms Of Stage 5 Ckd
You may have these symptoms in Stage 5 CKD if your kidneys begin to fail:
- Feeling weak and tired
- Swelling in your arms, hands, legs or feet
- Making little or no urine
- Pain in your lower back
- Muscle cramps
- Feeling sick to your stomach or throwing up
- Feeling less hungry than normal
- Trouble breathing
- Changes in your skin color
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Help Keep Your Kidney Disease From Getting Worse
Good self-management will help you to live a long, fulfilling life and continue to do the things you love. It can also help to slow or even stop kidney disease from getting worse – and it may even stop or delay kidney failure. Good self-management starts with:
- Controlling other health problems you may have
- Treating complications of kidney disease
- Managing or preventing heart disease
How Is Kidney Disease Diagnosed
First your healthcare provider will take your medical history, conduct a physical exam, ask about any medication you are currently taking, ask about any symptoms you have noticed, and inquire if any of your family members have kidney disease.
Your healthcare provider will order blood tests, a urine test and will also check your blood pressure.
The blood tests will check:
- Your glomerulofiltration rate . This describes how efficiently your kidneys are filtering blood how many milliliters per minute your kidneys are filtering. Your GFR is used to determine the stage of your kidney disease.
- Your serum creatinine level, which tells how well your kidneys are removing this waste product. Creatinine is a waste product from muscle metabolism and is normally excreted in your urine. A high creatinine level in your blood means that your kidneys are not functioning well enough to get rid it in your urine.
A urine protein test will look for the presence of protein and blood in your urine. Well-functioning kidneys should not have blood or proteins in your urine. If you do, this means your kidneys are damaged.
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