Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with rapid onset of nephrotic-range proteinuria and progressive decline in eGFR. History significant for [HIV status/APOL1 risk/idiopathic]. Symptoms include generalized edema, foamy urine, and fatigue. No prior history of chronic kidney disease.
Clinical Examination Findings
Physical exam reveals significant pitting edema (lower extremities/presacral), hypertension, and signs of volume overload. Patient appears chronically ill with evidence of muscle wasting. Weight gain noted since last visit.
Treatment Protocol
Initiate aggressive management: ACE inhibitor/ARB for antiproteinuric effect, loop diuretics for edema control, and statins for hyperlipidemia. Consider immunosuppressive therapy (e.g., corticosteroids, calcineurin inhibitors) based on biopsy findings and underlying etiology. Monitor eGFR and UPCR closely.