Snapshot A 56-year-old man presents to his primary care physician with shortness of breath and fatigue. He denies any chest pain but states that his wife noticed his legs appear swollen. Medical history is significant for hypertension and obesity. On physical exam there is dullness to percussion, decreased tactile fremitus, and dullness to percussion in the chest wall. There is pitting edema in the lower extremities. On laboratory testing, his glomerular filtration rate (GFR) 45 mL/minute/1.73 m2. Summary Clinical definition login to view 3 more bullets Epidemiology incidence login to view 1 more bullet risk factors login to view 7 more bullets Etiology insults that result in renal damage login to view 1 more bullet Pathogenesis login to view 16 more bullets Presentation Symptoms login to view 8 more bullets Physical exam login to view 7 more bullets Differential Acute on chronic kidney disease Studies Labs login to view 14 more bullets Biopsy login to view 1 more bullet Imaging Renal ultrasound login to view 4 more bullets Treatment Conservative login to view 3 more bullets Medical login to view 27 more bullets Operative login to view 3 more bullets Complications Anemia Mineral and bone disease Hypertension Hypervolemia Depression Cardiovascular disease Prognosis typically progressive loss of renal function and may result in ESRD