II) A 73-year-old woman underwent routine blood investigations and was found to have creatinine of 1.2 with estimated glomerular filtration rate of 40 ml/min. She has no risk factors or clinical features suggestive of kidney disease. What would be your approach to the patient? 

When a patient presents with mildly decreased kidney function, such as in this case where the estimated glomerular filtration rate (eGFR) is 40 ml/min, the approach to the patient should involve several steps. These steps include determining the cause of the kidney function decline, assessing the risk of progression to end-stage renal disease (ESRD), evaluating for complications of decreased kidney function, and initiating appropriate management to slow down the progression of the disease and prevent complications.

The following is an approach to the patient:

Step 1: Confirm the eGFR

The first step is to confirm the eGFR by repeating the test after a few weeks or months. This is because eGFR can fluctuate over time, and a single measurement may not be accurate.

Step 2: Evaluate the patient for risk factors and causes of kidney disease

The next step is to evaluate the patient for risk factors and causes of kidney disease. In this case, the patient does not have any known risk factors or clinical features suggestive of kidney disease. However, it is important to assess the patient's medical history, medication use, family history, and social history to identify any potential risk factors or causes of kidney disease. For example, a history of _______ ____ _________ ________ __________ ___.
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