Pulmonary Edema: This condition is a common cause of cough and fever in CKD patients, especially if they have underlying heart disease or volume overload. Palpitations can occur due to the stress of pulmonary edema on the heart.

Pneumonia: CKD patients are at increased risk of infections, including pneumonia, which can cause cough, fever, and palpitations due to hypoxia or the body's stress response.
Anemia: CKD patients often have anemia, which can lead to palpitations. If anemia is severe and acute, it might also precipitate heart failure, leading to cough and fever.
Electrolyte Imbalance: CKD patients are prone to electrolyte disturbances (e.g., hyperkalemia, hypokalemia, hypomagnesemia), which can cause palpitations. Severe imbalances can lead to life-threatening arrhythmias.

Endocarditis: Although less common, endocarditis is a serious condition that can present with fever and potentially cause palpitations due to embolic events or valve dysfunction. CKD patients might be at higher risk due to vascular access sites.
Sepsis: Any infection in a CKD patient can quickly escalate to sepsis, which would explain fever, cough (if pneumonia is the source), and palpitations due to the systemic inflammatory response.
Cardiac Tamponade: This is a life-threatening condition that could result from uremic pericarditis in CKD patients, presenting with cough (due to pericardial friction rub), fever, and palpitations due to impaired cardiac filling.

Arrhythmias Due to Uremic Toxins: Uremia can affect the heart's conduction system, leading to various arrhythmias, which might be perceived as palpitations. While not the first consideration, it's a possibility in advanced CKD.
Pulmonary Embolism: Although less likely without specific risk factors (e.g., recent immobilization, surgery), pulmonary embolism could cause cough, fever (if there's associated pneumonia), and palpitations due to right heart strain.