Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for follow-up of CKD G3b (eGFR 30-44 mL/min/1.73m²). Reports stable urinary output, denies gross hematuria or flank pain. No acute symptoms of uremia, nausea, or altered mental status. Adherent to current antihypertensive and phosphate-binding regimen.
Clinical Examination Findings
General: Alert and oriented x3, appears chronically ill but non-toxic. Skin: No evidence of uremic frost or excoriations. Hydration: Mucous membranes moist. Weight: Stable compared to last visit.
Treatment Protocol
Continue current ACEi/ARB therapy with close monitoring of serum creatinine and potassium. Initiate/adjust phosphate binders as indicated by labs. Maintain strict blood pressure control (<130/80 mmHg). Monitor for metabolic acidosis; consider sodium bicarbonate supplementation if serum bicarbonate <22 mEq/L.