15th July 2024

A 64-year-old man was found to have a creatinine of 253 µmol/L by his GP

A 64-year-old man was found to have a creatinine of 253 µmol/L by his GP.  He had a history of hypertension, type II diabetes and intermittent claudication.  Due to painful arterial ulcers of his lower limbs, he had recently been commenced on PRN Codeine and Ibuprofen in addition to his regular paracetamol. Urinalysis showed protein +.  Fundoscopy was unremarkable.

What is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.