Skill Checkup: A 41-Year-Old Man With New-Onset Abdominal and Flank Pain

Vecihi Batuman, MD


February 02, 2023

The Skill Checkup series provides a quick, case-style interactive quiz, highlighting key guideline- and evidence-based information to inform clinical practice.

A 41-year-old man in the United States presents with new-onset abdominal pain, which has been bothering him for the past week. About 3 days ago, he began experiencing flank pain as well. He is a nonsmoker with a moderate exercise routine. He has no significant medical history but has a family history significant for polycystic kidney disease (PKD); his father was diagnosed at age 47 years with PKD1 disease and reached end-stage kidney disease (ESKD) at age 52 years. Body mass index is 25 (height is 5 ft 11 in [1.8 m], and weight is 179 lb [81.19 kg]). Blood pressure (BP) is 138/92 mmHg, and estimated glomerular filtration rate (eGFR) is 81 mL/min/1.73 m2. A urinary panel shows neutrophil gelatinase-associated lipocalin (NGAL), and interleukin 18 (IL-18) excretion is mildly elevated.


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