What chronic kidney disease stage corresponds to an estimated glomerular filtration rate of 46 mL/min/1.73 m²?

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CKD Stage Classification for GFR 46 mL/min/1.73 m²

A GFR of 46 mL/min/1.73 m² corresponds to Stage G3a chronic kidney disease, defined as mildly to moderately decreased kidney function (eGFR 45-59 mL/min/1.73 m²) according to the KDIGO classification system. 1

KDIGO Staging Framework

The KDIGO classification stratifies chronic kidney disease by eGFR as follows: 1

  • Stage G1: ≥90 mL/min/1.73 m²
  • Stage G2: 60-89 mL/min/1.73 m²
  • Stage G3a: 45-59 mL/min/1.73 m² ← Your patient is here
  • Stage G3b: 30-44 mL/min/1.73 m²
  • Stage G4: 15-29 mL/min/1.73 m²
  • Stage G5: <15 mL/min/1.73 m² (kidney failure)

Clinical Significance of Stage G3a

  • Stage G3a represents loss of approximately one-third to one-half of normal kidney function and carries substantially increased risks compared to earlier stages. 1
  • This stage is associated with elevated cardiovascular disease risk, accelerated CKD progression potential, and increased mortality compared to stages G1-G2. 1

Diagnostic Confirmation Requirements

  • Chronic kidney disease diagnosis requires persistent abnormalities for at least three months; a single eGFR measurement of 46 mL/min/1.73 m² is insufficient to diagnose CKD. 1
  • Repeat the eGFR measurement within 3 months to verify chronicity and rule out acute kidney injury. 1
  • Do not rely on serum creatinine concentration alone to assess kidney function; eGFR must be calculated using validated equations. 1

Important Clinical Distinction

While your patient's GFR of 46 mL/min/1.73 m² places them in Stage G3a, it is critical to note that Stage G3b (30-44 mL/min/1.73 m²) carries significantly higher risks and warrants more aggressive monitoring and earlier nephrology involvement. 1 The subdivision of Stage 3 into 3a and 3b reflects meaningful differences in prognosis and management intensity.

Overlap with Normal Values

Healthy adults can have eGFR values as low as 63.5 mL/min/1.73 m² in some populations, meaning normal values overlap with CKD stages 1 and 2. 2 Therefore, an eGFR of 46 mL/min/1.73 m² definitively indicates reduced kidney function below the normal range and meets criteria for Stage G3a when persistent for ≥3 months.

References

1
Guideline

Management of eGFR 40 mL/min/1.73 m²

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

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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.

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