| Creatinine above normal on routine test | Dehydration, CKD, medication effect, muscle mass | Repeat test, eGFR calculation, urine review, cause workup, monitoring plan |
| Swelling in feet, ankles or face | Nephrotic syndrome, CKD, heart or liver disease | Urine ACR, albumin, lab review, salt restriction, diuretic plan with dietician input |
| Foamy urine | Proteinuria — possible CKD or glomerular disease | Urine protein quantification, kidney function tests, ACEi/ARB consideration |
| Blood in urine | Stones, UTI, glomerulonephritis, malignancy | Urine microscopy, ultrasound advice, cystoscopy referral if needed |
| BP not controlled on 2–3 medicines | Resistant hypertension, kidney involvement | Renal artery screening, medication review, renin-aldosterone workup |
| Severe loin pain radiating to groin | Kidney stone, ureteric colic | Ultrasound / CT KUB review, pain plan, urology referral, prevention diet |
| Reducing urine output | AKI, dehydration, obstruction | Urgent labs, hydration plan, hospital referral if AKI severe |
| Frequent UTIs in adults | Reflux, stones, diabetes, structural issue | Imaging review, prophylaxis plan, sugar control & gynae/urology coordination |
| Tired, itchy, poor appetite + raised creatinine | Advancing CKD, uraemia | Stage-specific CKD review, dialysis discussion, dietician renal plan |
| Diabetic with rising creatinine | Diabetic nephropathy | SGLT2 inhibitor consideration, ACEi/ARB, sugar & BP optimisation, renal diet |