MRCP2-3930

MRCP2-3930

A 45-year-old man with chronic kidney disease stage 5 due to autosomal-dominant polycystic kidney disease presents to the general nephrology clinic with complaints of increasing fatigue. He denies any changes in bowel habits or weight loss. On examination, his blood pressure is 120/56 mmHg, heart rate is 56 bpm, respiratory rate is 18/min, and Sats are 99% on air. His abdomen is soft and non-tender with palpable kidneys and an irregular liver edge. He is euvolemic.

Lab results show a hemoglobin level of 78 g/l, platelets of 167 * 109/l, WBC of 7 * 109/l, and ferritin of 95 ng/mL. B12 and folate levels are within normal range.

What is the most appropriate next step?