Renal and Pressure Ulcers--What do you do with Both?

I am in the process of revising my renal module, and I have seen several pts recently with poor renal function. Often times CKD is just a background condition, and something else is the current focus of medical professionals. I am sometimes a little unsure how to proceed when pts have a history of CKD or renal insufficiency, or labs that suggest poor renal function. Sometimes when I look at their GFR history I see a lot of fluctuation. Do these pts need to be on a protein restricted diet? How feasible is it to restrict protein in the diets of pts in long term care who have access to other sources of food? Also, how does such a restriction impact their quality of life? Their other health conditions?

On the other end of the spectrum, I have also seen patients recently with pressure ulcers and wounds, or with a recent history of them. I am having a hard time understanding how serious some of the wounds are due to the confusing chart notation. I spoke with the RD I am working with and she agrees that the notes are confusing. I spoke with some nurses who were partially able to clarify, but the one nurse I really needed to speak with was off on Friday. What do you do with patients who have pressure ulcers and a medical history that includes CKD? I think my chances of encountering such a patient are high given my current rotation in LTC. I have been reading about pressure ulcers and kidney disease, but I have not read anything about which takes priority when a patient has both. If anyone who reads this has encountered such a patient please send me an email.
Thanks!