Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for follow-up of CKD G4. Current eGFR 15-29 mL/min/1.73m². Reports [no/mild] uremic symptoms including fatigue, anorexia, or pruritus. Monitoring for fluid overload, electrolyte disturbances, and metabolic bone disease. Discussing RRT modalities (HD/PD/Transplant) and vascular access planning.
Clinical Examination Findings
General: Patient appears [well-nourished/chronically ill], alert and oriented. Skin: [Pale/sallow] complexion, no active excoriations. Hydration: Mucous membranes [moist/dry], no signs of significant volume depletion or overload.
Treatment Protocol
1. Optimize BP control (target <130/80 mmHg). 2. Adjust medication dosages for renal impairment. 3. Initiate/titrate phosphate binders and vitamin D analogs as indicated. 4. Manage anemia with ESA and iron supplementation if target Hb not met. 5. Referral for vascular access evaluation.