Chronic kidney disease stage 3b

Chronic kidney disease (CKD) stage 3b refers to a specific classification within the progressive deterioration of kidney function. In this stage, the kidneys are moderately impaired, indicating a significant decrease in their ability to filter waste and fluids from the blood. Let’s explore CKD stage 3b in more detail.

Definition of CKD Stage 3b

CKD is categorized into stages based on the estimated glomerular filtration rate (eGFR), which measures the kidney’s filtering capacity. Stage 3b is defined by an eGFR ranging from 30 to 44 milliliters per minute per 1.73 square meters. This stage signifies a moderate decline in kidney function.

Characteristics and Implications of CKD Stage 3b

  1. Symptoms: CKD stage 3b may be asymptomatic, meaning individuals might not experience noticeable symptoms. However, some common manifestations can occur, including fatigue, fluid retention, changes in urine output, and mild-to-moderate complications such as anemia and bone disease.
  2. Progression: At stage 3b, there is a higher risk of kidney function decline compared to earlier stages. Monitoring and management are crucial to slow down disease progression and prevent further damage.
  3. Underlying Causes: CKD can result from various underlying conditions, such as diabetes, hypertension, glomerulonephritis, polycystic kidney disease, or other primary kidney disorders. Identifying the cause helps guide treatment and management strategies.
  4. Complications and Coexisting Conditions: CKD stage 3b may be associated with complications like anemia, bone disease, electrolyte imbalances, and cardiovascular problems. Coexisting conditions, such as diabetes or hypertension, should also be addressed and managed appropriately.

ICD-10 Coding for CKD Stage 3b

To accurately code CKD stage 3b according to the ICD-10 system, the following codes are relevant:

  1. Primary Code: N18.3 (Chronic kidney disease, stage 3).
  2. Additional Codes: Assign additional codes to indicate the underlying cause, associated complications, and any coexisting conditions. For example, E11.22 (Type 2 diabetes mellitus with diabetic chronic kidney disease) and I10 (Essential (primary) hypertension).

Documentation and Management

Accurate documentation is crucial for appropriate coding and management of CKD stage 3b. Healthcare professionals should focus on:

  1. CKD Stage: Document the stage based on the patient’s eGFR and other relevant indicators.
  2. Underlying Cause: Clearly specify the underlying cause of CKD, such as diabetes, hypertension, or specific nephropathy.
  3. Complications and Coexisting Conditions: Document any associated complications, such as anemia or bone disease, and address any coexisting conditions to ensure comprehensive care.

Management of CKD stage 3b includes

  • Lifestyle modifications: Promote a healthy diet, exercise, smoking cessation, and weight management to reduce risk factors and slow disease progression.
  • Blood pressure control: Maintain optimal blood pressure levels through medication, dietary changes, and lifestyle modifications.
  • Blood sugar control: For individuals with diabetes, manage blood sugar levels effectively to minimize kidney damage.
  • Medications: Prescribe medications to manage symptoms, complications, and coexisting conditions.
  • Regular monitoring: Monitor kidney function, blood pressure, and other relevant parameters regularly to track disease progression and adjust treatment plans accordingly.


CKD stage 3b signifies a moderate decline in kidney function, requiring proper documentation, coding, and management. Accurate coding using the ICD-10 system, with specific attention to underlying causes, associated complications, and coexisting conditions, ensures appropriate diagnosis, treatment, and reimbursement. Timely intervention, lifestyle modifications, and close monitoring can help slow down disease progression and improve outcomes for individuals with CKD stage 3b.

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