![]() Stage 3 CKDStage 3 CKDIn Stage 3 CKD e. GFR is approximately 3. GFR 4. 5- 5. 9 (3. A) or 3. 0- 4. 4 (3. B). Remember that e. GFR is an estimate (more info on e. GFR) and may require a correction for (black) race. Creatinine and e. ![]() GFR in an individual are usually quite stable. Deteriorating renal function needs rapid assessment. Note that CKD staging and management outlined below are only applicable to stable renal function. Assessment and management of Stage 3 CKD. Most Stage 3 CKD can be appropriately managed in primary care. The aim is to identify individuals at risk of progressive renal disease, and reduce associated risks. Risk of cardiovascular events and death is substantially increased by the presence of CKD. ![]() ![]() Third Stage Kidney Disease. Stage 3 chronic kidney disease is define as having moderate kidney damage. Diet in Stage 3 Chronic Kidney Disease. In the third stage of kidney failure. What are some diet tips for diabetics with kidney disease? A: Diabetics with chronic kidney disease, or CKD. The risk of cardiovascular death is (on average) much higher than the risk of needing dialysis or a renal transplant. Some patients need further investigation where there are indications that progression to end stage renal failure (Stage 5) may be likely. Pointers to progression of renal disease are: Proteinuria - the risk is graded, but a common cut- off for investigation is ACR> 7. I Have Late-Stage Kidney Disease. 8 Diet and Nutrition Goals for People with Stage 3 Chronic Kidney Disease. Chronic Kidney Disease Stage 3 Diet. The primary objectives of a diet for stage 3 chronic kidney disease are to slow the progression of CKD and treat. Ask for our free educational brochures on diet and kidney disease. Diet and nutrition are an. Click on the appropriate stage below to learn more about diet. PCR> 1. 00 Haematuria of renal origin Declining GFR - more info. Young age Long term monitoring of renal function and other parameters is indicated. Is there a history of significant associated disease? Consider referral if systemic disease process involving kidneys supported by urinary abnormalities or other indicators. ![]() If assessment is precipitated by a first discovery of elevated creatinine, it is important to be certain that the value is stable. Maybe there are previously recorded values? If not, and the patient is well, repeat test within 1. Ideally this sample should be taken after a period of at least 1. Deteriorating renal function needs rapid assessment. Clinical assessment - especially for sepsis, heart failure, hypovolaemia, examination for bladder enlargement (imaging indicated if obstruction suspected from symptoms or examination). Medication review - any potentially nephrotoxic drugs, or drugs that need dose alterations when GFR reduced? ![]() Urine tests: dipstick for blood and quantitation of proteinuria by ACR/PCR. Presence of haematuria or proteinuria may suggest progressive renal disease. Imaging - exclusion of obstruction is indicated in patients with singnificant urinary symptoms or other things to suggest obstruction. See referral by urgency. Management of Stage 3 CKD6 then 1. Creatinine and K - consider an unexplained fall in e. GFR of > 2. 5% to be acute renal failure. NICE suggest seeking specialist advice for a loss in GFR over 1y of 5ml/min, or a loss of GFR in 5y of 1. More on deteriorating function. Hb - if low, exclude non- renal cause. Below 1. 10 g/l, specific therapy may be considered. Hb falls progressively as GFR falls, but renal anaemia rarely becomes significant before stage 3. B or 4 CKD. More on anaemia. Urinar y protein for ACR or PCR. Note thresholds; ACR 3. PCR 5. 0 for more stringent blood pressure targets (and suffix 'p' on CKD stage), and ACR 7. PCR 1. 00 for specialist referral/discussion. More on proteinuria. Blood pressure - 1. ACR> 3. 0 or PCR> 5. More on hypertension. Cardiovascular risk - advice on smoking, exercise and lifestyle. Consider cholesterol lowering therapy if already have macrovascular disease, or if estimated 1. More on CV risk in CKDImmunization - influenza and pneumococcal Medication review - regular review of medication to minimise nephrotoxic drugs (particularly NSAIDs) and ensure doses of others are appropriate to renal function. Patient info - Stage 3 CKDMost patients with Stage 3 CKD are older, and only a minority go on to get more serious kidney disease. Their increased rate of cardiovascular disease (heart attacks, strokes, narrowing of other arteries) is very important. However some do go on to get severe kidney failure, and there are some pointers that make this seem more likely. Further information about blood tests and kidney function from the Edinburgh Renal Unit website. Further information for patients about chronic kidney disease and the K/DOQI stages from Ed. RENMore guidance on CKD and e. GFR is available from the foot of the e.
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