Conversation: The conversation between human and AI assistant.
[|Human|] wife (68) has stage 4 kidney failure-taking nefedipine-colodine*sodium bicarbonate-calcium acitate- 22 units of insulin once a day and 50000unite vit d every two weeks- is time she is sick and wants to vomit with back pain and chills-what is going on-what does this mean?
[|AI|]  Hi thanks for writings you have said your wife has CKD 4. The symptoms such as nausea, omitting, poor appetite, muscle aches may be symptoms of advance kidney dysfunction. The renal function should be checked and if creatinine is high patient might need dialysis. Meanwhile, symptomatic treatment for omitting should be offered. I will be glad to answer any queries. Ply attach recent labs when you communicate next time. Tx