A 42 year old female came to the hospital with chief complaints of pedal edema, shortness of breath and decreased urine output since 6 months.


HISTORY OF PRESENT ILLNESS:-


The patient was apparently asymptomatic 6 months ago and then she developed pedal edema, which was gradual in onset, progressive along with shortness of breath (grade III-IV) along with decreased urine output. She then came to this hospital for further evaluation.


HISTORY OF PAST ILLNESS:-


She is not a known case of diabetes mellitus, CVA, TB, asthma. She had hypertension since 6 months.


TREATMENT HISTORY:-


The patient had a blood transfusion in the past. She is also regularly taking medicines for her symptoms. She had a C-Section surgery 20 years ago.


PERSONAL HISTORY:-


Diet: Mixed, but ever since the onset of her symptoms, she stopped consuming non-vegetarian food.


Appetite: decreased


Bowels: irregular


Micturition: decreased


FAMILY HISTORY:-


No history of diabetes, hypertension, heart disease or stroke, tuberculosis, cancer. Patient's sibling has diabetes.


GENERAL EXAMINATION:-


The patient was conscious, coherent, and cooperative and examined in a well lit room.


    VITALS:


    . Pulse rate: 70bpm


    . respiratory rate: 23 breaths/min


    . BP: 130/80 mm Hg


    . SPO2: 98%


    PHYSICAL EXAMINATION:


    . Pallor: present


    . Icterus: absent


    . Cyanosis: absent


    . Clubbing of fingers and toes: absent


    . Lymphadenopathy: absent


    . Pedal edema: present bilaterally, upto ankle, non-pitting type


    . Malnutrition: eats less due to decreased appetite.


SYSTEMIC EXAMINATION:-


CVS: S1, S2 sounds heard.


No thrills, no murmurs.


Respiratory system: BAE+, normal vesicular breath sound present


Abdomen: Shape of abdomen - scaphoid. No tenderness, no palpable mass, no organomegaly


CNS: Conscious and normal speech, normal gait, cranial nerves normal, sensory system normal, motor system normal, no signs of meningeal irritation.


INVESTIGATIONS:-

ECG:-







Serum Iron:-




Serum Electrolytes:-



Serum Creatinine









Provisional diagnosis                                     
CKD     

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