26th February 2025

You are reviewing a 68-year-old male in renal clinic with your consultant.

You are reviewing a 68-year-old male in renal clinic with your consultant. He has been referred by his general practitioner due to abnormal renal function and peripheral oedema. You perform a thorough systems review, and he tells you that he has been feeling generally fatigued and has noticed that he has marks on the side of his tongue where his teeth dig in. On examination you note that he has pitting oedema bilaterally to the legs and subtle periorbital oedema. His JVP is elevated, and you can also feel hepatomegaly.

He has a past medical history of hypertension, MGUS and hypercholesterolaemia.

Blood tests performed at the GP show:

 Urinalysis: nitrites negative, leucocytes negative, protein 3+, blood negative.

What is the most likely diagnosis?

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