Clinical case:
A 52-year-old man presented with complaints of general weakness, lower back pain, and urine discoloration. He had a history of hypertension. A physical examination revealed a blood pressure of 160/95 mmHg and moderate leg swelling.
Laboratory test results:
| Indicator | Result | Norm |
| Hemoglobin | 118 g/l | 120–160 |
| Creatinine | 170 μmol /L | 60–110 |
| Urine | 9.8 mmol /L | 2.5–8.3 |
| Protein in urine | 0.8 g/l | 0 |
| Red blood cells | 8–10 | 0–2 |
Instrumental examination:
Ultrasound examination of the kidneys: the density of the renal parenchyma is increased, the size is slightly reduced.
Clinical questions:
1. Determine the probable diagnosis.
2. Indicate the differential diagnosis. 3. What additional diagnostic tests are needed? 4. Determine the treatment strategy. 5. Assess the prognosis and possible complications.
Case discussion
The patient's clinical symptoms and laboratory abnormalities indicate impaired renal function. Elevated creatinine levels and proteinuria may indicate glomerular or tubulointerstitial damage . Differential diagnosis includes nephropathy and chronic kidney disease.
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