From the Research
Approximately 15% of patients with Chronic Kidney Disease stage 3a (CKD3a) progress to more advanced stages of kidney disease over time, with those having CKD3aA3 being at higher risk of progression to CKD stage 5, heart failure, hypertension, and retinopathy compared to CKD3aA1 or CKD3aA2. This progression rate varies significantly based on individual risk factors, such as the degree of albuminuria, with patients having higher levels of albuminuria (CKD3aA3) being at increased risk of progression 1. Patients with proteinuria, diabetes, hypertension, or older age tend to progress more rapidly, while those with well-controlled blood pressure, minimal proteinuria, and good glycemic control (if diabetic) show slower progression. The rate of GFR decline in CKD3a typically averages about 1-3 mL/min/1.73m² per year in most patients, though this can be faster in high-risk individuals.
- Key factors influencing progression include:
- Degree of albuminuria
- Presence of diabetes
- Level of blood pressure control
- Presence of proteinuria
- Regular monitoring of kidney function every 6-12 months is recommended for CKD3a patients to track progression, with lifestyle modifications (low-sodium diet, regular exercise, smoking cessation) and medications like ACE inhibitors or ARBs potentially slowing progression in appropriate patients 2, 3.
- The use of ACE inhibitors or ARBs in patients with CKD3a may help prevent kidney failure, with some studies suggesting that these medications can reduce the risk of kidney failure and slow the progression of kidney disease 3.
- However, the evidence for the effectiveness of these medications in preventing progression of CKD3a is not strong, and more research is needed to fully understand their benefits and risks 2, 3.