Differential Diagnosis for 83-year-old Female Patient
Single Most Likely Diagnosis
- Chronic Kidney Disease (CKD): The patient's elevated creatinine level (1.23 mg/dL) and high BUN/creat ratio (15) suggest impaired kidney function, which is consistent with CKD. The patient's age and elevated calcium level may also contribute to this diagnosis.
Other Likely Diagnoses
- Dehydration: The patient's elevated BUN (18 mg/dL) and sodium (144 mmol/L) levels may indicate dehydration, which can exacerbate kidney function and contribute to elevated creatinine levels.
- Hyperparathyroidism: The patient's high calcium level (10.2 mg/dL) may be indicative of hyperparathyroidism, which can be primary or secondary to CKD.
- Nephrotic Syndrome: The patient's low albumin level (3.5 g/dL) may suggest nephrotic syndrome, which can be caused by various kidney diseases, including CKD.
Do Not Miss Diagnoses
- Acute Kidney Injury (AKI): Although the patient's creatinine level is only slightly elevated, AKI should be considered, especially if the patient has a history of kidney disease or has been exposed to nephrotoxic agents.
- Hypercalcemia of Malignancy: The patient's high calcium level may be indicative of an underlying malignancy, which would require prompt evaluation and treatment.
- Sepsis: The patient's elevated BUN and creatinine levels may be indicative of sepsis, which can cause acute kidney injury and requires prompt treatment.
Rare Diagnoses
- Multiple Myeloma: The patient's high calcium level and low albumin level may suggest multiple myeloma, a rare plasma cell disorder that can cause kidney damage and hypercalcemia.
- Familial Hypocalciuric Hypercalcemia: The patient's high calcium level may be indicative of this rare genetic disorder, which can cause hypercalcemia and kidney stones.
- Medullary Sponge Kidney: The patient's elevated creatinine level and high BUN/creat ratio may suggest this rare kidney disorder, which can cause kidney stones and impaired kidney function.