Question

A 58-year-old man with CKD stage 5 (eGFR 9 mL/min/1.73 m²) reports anorexia, nausea, pruritus and declining functional status despite optimal medical therapy. Potassium and fluid are difficult to control. What is the most appropriate next step?

Accepted Answer

Discuss and plan initiation of dialysis or conservative care according to patient preferences

Answer

Delay dialysis until he develops overt pulmonary oedema

Answer

Dialysis should only start when creatinine exceeds 1000 µmol/L

Answer

No need for discussion until he becomes anuric

Answer

Start high-dose NSAIDs for symptom control

Practice question

A 58-year-old man with CKD stage 5 (eGFR 9 mL/min/1.73 m²) reports anorexia, nausea, pruritus and declining functional status despite optimal medical therapy. Potassium and fluid are difficult to control. What is the most appropriate next step?