What does stage 3 CKD with GFR of 45 mean?

Question

Hello doctor,

My 58-year-old mother was just told she has stage 3 CKD with a GFR of 45 and was trying to understand what this means for her future. She has had diabetes and high blood pressure for 15 years, but her kidney function was always normal until recent labs.

Her creatinine jumped from 1.2 to 1.8 over the past six months, and now the nephrologist says she has chronic kidney disease. She is worried about needing dialysis someday and what that would mean for her independence. Also takes several medications, including Lisinopril and Metformin, that the doctor says might need adjusting.

Her ankles have started swelling in the evenings, and she gets tired more easily than before. Most concerning is that her hemoglobin dropped to 10.2, and she needs iron supplements now. Scared about dietary restrictions because she loves cooking traditional foods that are high in salt and protein. Can CKD progression be slowed down if caught this early?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

Stage 3 chronic kidney disease (CKD) with a GFR (glomerular filtration rate) of 45 means your mother has moderate loss of kidney function, and while this is a serious diagnosis, many people can live for years without reaching dialysis if the disease is managed carefully. Since her diabetes and high blood pressure are the main drivers of kidney damage, strict control of both is the most important step, keeping blood sugars in target range, blood pressure ideally below 130/80, and continuing medicines like Lisinopril, which protect the kidneys, though doses may need adjusting as kidney function changes.

Metformin is usually safe until kidney function drops further, but her doctor will keep monitoring to avoid side effects. The swelling in her ankles and fatigue are signs that her kidneys are not filtering as efficiently, and the drop in hemoglobin reflects kidney-related anemia, which can be treated with iron and sometimes additional medications if needed.

Dietary adjustments, particularly reducing salt to control blood pressure and fluid retention, as well as moderating protein intake to avoid excess kidney strain, can make a big difference, though she can still enjoy traditional foods with some modifications, like using less salt and smaller portions of meat. It is important to know that CKD does not always progress to dialysis, especially when caught at this stage. Slowing progression is very possible with lifestyle measures, regular monitoring, and tailored treatment.

Staying active, avoiding smoking, keeping her weight healthy, and working closely with her nephrologist will all help preserve her kidney function and quality of life for as long as possible.

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.