A 50yr old female resident of suryapet came to the op with chief complaints of 

back pain

Fever 

Bilateral pedal edema 

Puffiness of face

History of present illness

Patient was asymptomatic 6months back then she developed the back pain ,fever and pedal edema

Past history

k/c/o HTN since 7yrs Medication not known

No History of DM,TB, epilepsy


Personal history

Appetite - decreased

Diet- mixed

Sleep-inadequate

No addictions

Bladder movements are normal 

But she has c/o constipation

Family history

No significant family history

General examination

No icterus, pallor,cyanosis,clubbing,lymphadenopathy

Bilateral pedal edema and facial puffiness are present

Vitals

BP 180/110mmhg

Pulse-88 beats/min

Temp-97°F

RR -18 CPM

Systemic examination

RS :B/L inspiration crestfallen over lung fields

CVS:S1 and S2 are heard, no murmurs

CNS:No focal deformities


Investigations

Haemogram

Hb: 7.5gm/dl

TLC:7800/cumm

PCV:23.3

RCB:2.6million /cumm

PLT:1.54lakh/cumm

RFT

urea:46mg/dl

Creatinine:3.6mg/dl

Uric acid:2mg/dl

Calcium:8.9mg/dl

Phosphorous:2.3mg/dl

Sodium:143meq/dl

Potassium:3.8meq/dl

Chloride:99meq/dl


Provisional diagnosis 

-?CKD


Treatment 

Fluid restriction <1.5L/day

Salt restriction <2gm/day

Tab Lasix 40mg

Tab Nicardia

Tab livogenx

Tab Nodomis 500mg

Tab bio d3 



 







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