Does impaired renal function with a GFR of 31 correspond to stage 3b Chronic Kidney Disease (CKD)?

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Last updated: February 21, 2025 • View editorial policy

From the Guidelines

Yes, a GFR of 31 mL/min/1.73m² corresponds to Stage 3b Chronic Kidney Disease (CKD). CKD is classified into stages based on the estimated glomerular filtration rate (eGFR). Stage 3 is divided into two sub-stages:

  • Stage 3a: eGFR 45-59 mL/min/1.73m²
  • Stage 3b: eGFR 30-44 mL/min/1.73m² With a GFR of 31, the patient falls into Stage 3b CKD, as defined by the most recent and highest quality study 1. This indicates moderate to severe kidney damage with significantly reduced kidney function.

Management for CKD 3b typically includes:

  • Blood pressure control (target <130/80 mmHg)
  • Glycemic control if diabetic (target HbA1c <7%)
  • Lipid management
  • Dietary modifications (low sodium, moderate protein)
  • Regular monitoring of kidney function and electrolytes
  • Avoiding nephrotoxic medications
  • Consideration of referral to a nephrologist Patients at this stage should be monitored for complications such as anemia, bone disease, and metabolic acidosis, as highlighted in 2. They may also need adjustments to medication dosages that are cleared by the kidneys.

Understanding the stage of CKD helps in predicting the risk of progression to kidney failure and guides appropriate management strategies to slow disease progression and manage complications, as emphasized in 3 and 4. The classification of CKD stages is crucial for determining the best course of treatment and management, and a GFR of 31 mL/min/1.73m² clearly falls within the Stage 3b category.

From the Research

Definition of Chronic Kidney Disease (CKD) Stages

  • CKD is typically classified into five stages based on the glomerular filtration rate (GFR) 5.
  • Stage 3 CKD is further subdivided into two subgroups: stage 3A (eGFR 45-59 mL/min/1.73 m2) and stage 3B (eGFR 30-44 mL/min/1.73 m2) 5, 6.

Impaired Renal Function with a GFR of 31

  • A GFR of 31 corresponds to stage 3B CKD, which is characterized by a moderate to severe decrease in kidney function 5, 6.
  • Patients with stage 3B CKD are at a higher risk of progressing to end-stage renal disease (ESRD) compared to those with stage 3A CKD 5, 6.

Clinical Implications

  • The risk of renal failure in patients with stage 3B CKD is often under-recognized in standard medical screening 6.
  • Early identification and management of stage 3B CKD are crucial to prevent or delay the progression to ESRD 7, 8, 9.
  • Treatment of metabolic acidosis in patients with stage 3 CKD, including those with stage 3B, may help preserve GFR and reduce the risk of renal failure 9.

References

Guideline

standards of medical care for type 2 diabetes in china 2019.

Diabetes/Metabolism Research and Reviews, 2019

Research

Clinical Practice Guideline on management of older patients with chronic kidney disease stage 3b or higher (eGFR<45 mL/min/1.73 m2): a summary document from the European Renal Best Practice Group.

Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2017

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.