This chapter, written for undergraduate medical students and post-graduate doctors in training, presents information on how to manage renal problem — a case which they are likely to encounter in the future in a general practice setting. It presents the case of a 68-year-old Afro-Caribbean man who attends the surgery asking him to return for a follow-up appointment because of abnormalities found in his blood test. Checking the prescription record, he finds that the patient had ordered and collected his prescription for amlodipine regularly at 8-week intervals. The chapter provides details of the patients' medical history and the key findings of clinical examination, together with initial investigation results data for evaluation, and helps them develop their skills of clinical reasoning. Key questions then prompt the student to evaluate the patient, and reach a decision regarding their condition and the possible treatment plan.