2 Months Of Progressive in Medicine / Internal Medicine — 50yo Man | Nephrology | SMLE Q#17856
SMLE Question #17856
Medicine / Internal Medicine
Nephrology
Objective: OBJ-CKD-UR-001
Last updated: February 2026
A 50-year-old man with chronic kidney disease for 3 years presents with 2 months of progressive numbness and tingling in both feet and hands with unsteady gait. He is not on renal replacement therapy. Examination shows reduced pinprick and vibration sense below the knees bilaterally and absent ankle reflexes with preserved motor strength. What is the most appropriate next step in management?
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