Talk to Nephrologist on Chronic Kidney Disease + Uterine Prolapse

Patient is an 80-year-old female with chronic kidney disease and acute worsening, currently having a creatinine of 349 µmol/L. She has reduced urine output (only 2 times/day), swelling in legs and body, and high blood pressure. She also has a 3rd-degree uterine prolapse with an ulcer; surgery is not possible due to her age and frailty. She is currently under ulcer packing and wound care, with plans for pessary insertion. There is a risk of urine retention, which could worsen kidney function. Consultation is requested for review of kidney status, urine management (possible catheter), medication adjustment, fluid and diet guidance, and advice for online/remote follow-up, as she cannot travel frequently to Islamabad.