Nephrology & Renal Medicine

Chronic Kidney Disease, Stage G3a

ICD-10 Code

N18.31

Mild to moderate decrease in eGFR (45-59 mL/min/1.73m²). Patients are largely asymptomatic but begin to develop early complications of CKD such as hypertension, early bone mineral disorder, and mild anemia.

Clinical Presentation & Protocol

Patient Usually Complains Of

Patient presents for follow-up of CKD Stage G3a (eGFR 45-59 mL/min/1.73m²). Denies gross hematuria, flank pain, or significant edema. Reports stable urinary output. Currently monitoring BP at home; denies orthostatic symptoms. No significant fatigue or pruritus reported.

Clinical Examination Findings

General: Patient appears well-nourished and in no acute distress. Vitals: BP stable, within target range. Skin: No evidence of uremic frost or excoriations. Hydration: Mucous membranes moist, no clinical signs of volume depletion or overload.

Treatment Protocol

Continue current nephroprotective regimen. Optimize BP control (target <130/80 mmHg) using ACEi/ARB as tolerated. Maintain hydration. Monitor serum creatinine, electrolytes, and PTH levels. Avoid nephrotoxic agents (NSAIDs). Refer to renal dietitian for protein intake optimization.

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