Kidney Diet Tips

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Kidney Health 101: What are Stages 3 and 4 Kidney Disease?

Recently, we discussed chronic kidney disease (CKD) stages 1 and 2, in which the disease doesn’t yet affect the kidney’s ability to filter blood (stage 1) or causes only a mild decrease in filtration (stage 2). As kidney disease progresses, it is classified as stage 3 or 4 based on how much kidney function remains. Many kidney patients are diagnosed in stages 3 and 4 because earlier stages can be difficult to detect and diagnose at an earlier time.

Stage 3 Kidney Disease

Moderate kidney damage (stage 3) means your kidneys are having more difficulty filtering waste and extra fluid from your blood than in stage 2. Stage 3 can be identified by a blood test measuring your glomerular filtration rate (GFR) (the flow rate of blood through the kidney): either 45–59 mL/min (known as 3A) or 30–44 mL/min (known as 3B). In stage 3, you may start experiencing symptoms such as fatigue, fluid retention, changes in urination, kidney pain in your back, and sleep problems due to muscle cramps or restless legs. In addition to what’s happening with your kidneys in this stage, your doctor may also discuss how kidney disease can affect your overall health, including high blood pressure or even early bone disease.

Stage 4 Kidney Disease

Late stage kidney disease (stage 4) means your kidneys have a significant loss of function. In stage 4, you’ll have a severe decrease in your GFR: 15 – 30 mL/min. In addition to stage 3 symptoms, you may experience nausea and vomiting, a metallic taste in your mouth or bad breath, loss of appetite, difficulty concentrating, as well as numbness or tingling in your toes or fingers.

Dietitians and CKD

Your nephrologist may suggest talking with a dietitian. Proper nutrition can help you maintain kidney health in earlier CKD stages, but a kidney-friendly diet in stages 3 and 4 can be especially important. A dietitian will review your lab work and can help create a meal plan specific to your needs for stage 3 or stage 4 CKD. They can help you understand what nutrients to include in your diet and what you may need to limit, such as phosphorus- or potassium-rich foods, high-sodium foods and excess carbohydrates (if you have or are at risk of diabetes). In addition, your daily protein requirements will be calculated as part of your meal plan.

You can learn more about diet and nutrition on the Kidney Diet Tips blog or using the links below; however, always talk with your doctor or dietitian to make sure you’re following the right guidance for you.

Additional Kidney Diet Resources

Visit DaVita.com and explore these diet and nutrition resources:

This article is for informational purposes only and is not a substitute for medical advice or treatment. Consult your physician and dietitian regarding your specific diagnosis, treatment, diet and health questions.

Kidney Diet & Health Tips Team

Kidney Diet & Health Tips Team

The Kidney Diet & Health Tips Team offers insights and tips on kidney health.