A 72-yeаr-оld mаn with lоng-stаnding type 2 diabetes and hypertensiоn reports progressive fatigue, mild ankle edema, decreased appetite, and reduced exercise tolerance. His kidney function has slowly worsened over several years. Labs show creatinine 2.4 mg/dL (normal: 0.6–1.3 mg/dL), eGFR 28 mL/min/1.73 m² (normal: ≥90 mL/min/1.73 m²), potassium 5.3 mEq/L (normal: 3.5–5.0 mEq/L), and hemoglobin 9.8 g/dL (normal adult male: 13.5–17.5 g/dL). The NP bases the plan of care on the understanding that…
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