Which of the following are correct about acute glomerulonephritis: (Select all that apply)

A. 90-year-old female whose blood urea nitrogen (BUN) is rising: An isolated rise in BUN can indicate dehydration, gastrointestinal bleeding, or renal impairment. While BUN may increase slightly with age, a significant rise should not be dismissed as normal aging and warrants further investigation.

B. 81-year-old male whose serum creatinine level has increased sharply since his last blood work: A sharp increase in creatinine is not typical with aging and may suggest acute kidney injury or worsening chronic kidney disease. In older adults, even small creatinine changes can be significant due to reduced muscle mass.

C. 80-year-old male whose dipstick urine reveals protein is present: Proteinuria is not a normal part of aging and may indicate underlying kidney damage, hypertension, or diabetes. Even trace amounts of protein in the urine of older adults should prompt further evaluation to rule out nephropathy.

D. 78-year-old female whose GFR has been steadily declining over several years: A gradual decline in glomerular filtration rate (GFR) is expected with aging due to nephron loss and reduced renal perfusion. This change is a normal physiologic part of aging, provided there are no abrupt drops or accompanying signs of renal disease.

A. Increase their intake of cranberry juice and other fluids: While cranberry juice and increased fluids may help prevent or relieve mild urinary tract infections, the presence of blood in the urine (hematuria) and lower abdominal pain may indicate a more serious condition that requires professional evaluation rather than home remedies alone.

B. Wait and see if it goes away without treatment: Ignoring hematuria and pain can delay diagnosis and treatment of potentially serious conditions such as infections, stones, or other urinary tract problems. Prompt assessment is important to prevent complications.

C. Go to the emergency room right away: Unless symptoms are severe, such as uncontrollable pain, fever, or signs of systemic infection, immediate emergency care may not be necessary. However, timely medical evaluation is still essential.

D. Get an appointment with their family provider: This is the most appropriate advice because a healthcare provider can perform necessary assessments, such as history, physical exam, and diagnostic tests, to determine the cause of hematuria and pain and initiate appropriate treatment.