Hello, I need help with an I-human case for Ken Fowler



Name: Ken Fowler

Age: 70 years

Sex: M

Ht: 5'10" (178.0 cm)

Wgt: 190 lb (86.0 kg) (BMI 27.3)



T = 99F (oral)

Pulse: 98 bpm

BP 108/60 mmHg - supine / sitting

BP: 94/46 mmHg - upon standing

RR: 18 bpm

SpO2: 98% on rm air



CC is Nausea & Fatigue

Patient states:

"I went to see my doctor this morning because I have been feeling bad for the past few days. I'm tired, with nausea & vomiting. Well, he examined me and ordered some labs, and then told me that "kidneys are failing," something about a big change in my creatinine and that I needed to come to the emergency department. He told me to bring the test results here with me. [Test results today: creatinine 3.2 mg/dL; 1 month ago Test results 1.1 mg/dL; urine protein = 400 mg microalbuminuria] Do you understand what all that means? I sure don't!"



Do you know any possible differential diagnosis as well as primary. And treatment plan