What Does CKD Stage 3 Mean?

The two most common causes in Australia are:

• Diabetes — the leading cause. High blood glucose damages the small blood vessels in the kidneys over time.
• High blood pressure (hypertension) — the second most common cause. Elevated pressure damages kidney blood vessels.

Other causes include glomerulonephritis (immune-mediated kidney inflammation), polycystic kidney disease (genetic), recurrent kidney infections, and prolonged use of certain medications (including NSAIDs such as ibuprofen and naproxen).

Stage 3 CKD does not inevitably progress to kidney failure. Many people remain at Stage 3 for years or decades with good management. Your GP will:

• Monitor eGFR and urine albumin-to-creatinine ratio (ACR) at least annually — more often if Stage 3b or if ACR is elevated
• Manage blood pressure closely — target is usually below 130/80 mmHg in CKD
• Optimise blood glucose control if diabetes is the cause
• Review medications — some drugs are unsafe or need dose adjustment at lower eGFR (metformin, NSAIDs, certain antibiotics, contrast agents)
• Check for and treat anaemia, bone disease, and electrolyte imbalances — these can occur as eGFR falls
• Refer to a nephrologist (kidney specialist) for eGFR below 30, rapidly declining eGFR, or difficult-to-manage complications

Kidney Health Australia provides free education, support, and a national helpline for people with CKD. Many people with CKD Stage 3 are eligible for a GP Management Plan, giving access to subsidised dietitian care (dietary protein and salt modification can slow progression) and other allied health services.

Staying well-hydrated, avoiding NSAIDs and nephrotoxic substances, maintaining a healthy weight, controlling blood pressure and blood glucose, and not smoking are the most impactful things you can do to protect your remaining kidney function.