Station - Instructions for candidate
You are an intern in the Renal Outpatient Clinic at a Perth tertiary hospital.
Wei Zhang is a 62-year-old farmer from the Wheatbelt who has had progressive kidney disease for several years. His kidney function has now declined to a critical level and he has come in today to discuss his treatment options. His recent blood work confirms he is at stage where renal replacement therapy is urgently needed.
| Latest eGFR (this month) | 12 mL/min/1.73 m2 (down from 18 three months ago) |
|---|---|
| Serum creatinine | 487 umol/L |
| Urea | 18.5 mmol/L |
| Potassium | 4.9 mmol/L |
| Haemoglobin | 108 g/L |
| Urinary albumin:creatinine ratio | 280 mg/mmol |
| Blood pressure (today) | 148/92 mmHg, regular pulse 78 |
Your tasks are to:
- Take a focused history about his current symptoms, functional status and social situation.
- Explain his diagnosis and the urgent need for treatment, and present the four main renal replacement therapy options and the rural logistics of each.
- Explore his values, concerns and preferences for each treatment option.
- Outline a full management plan including next steps, follow-up arrangements and safety-netting.
- You do NOT need to summarise your findings to the examiner.
This is a 15-minute station, with 2 minutes of reading time.