4.Chronic kidney disease


CASE:- Chronic kidney disease 


CheIf complaint - 

 40 year old man , is a farmer by occupation came with the complaints of

Pedal edema  since 3 months , along with facial puffiness , Shortness of breathe ( Grade 4) and 

Decreased urine output since 3 months


HISTORY OF PAST ILLNESS:-



Not a known case of hypertension, diabetes, asthma, epilepsy, tuberculosis.


PERSONAL HISTORY:-


Patient takes mixed diet, normal appetite

sleep adequate(sleeps about 6-7 hours at night, wakes up early in the morning for work).

Bowel and bladder habits are regular.

No addictions.



GENERAL EXAMINATION:-


On examination: 

Patient is conscious, coherent

Vitals-

Temp: afebrile

PR: 84. bpm

BP: 130/70 mm hg

RR: 24 cpm

GRBS: 136  mg /dl 

SPo2 - 98% 


No Pallor 

No Icterus

No signs of cyanosis, clubbing, koilonychia. 

Pedal edema is present . 



PER ABDOMEN: soft, non tender

CVS: S1S2 heard

RS: BAE +, NVBS+

CNS: NAD 


Investigations:

Hb: 8.0 gm/ dl

Tlc: 16,800 cells/mm3

Platelets: 4.8 lakhs/mm3

Total bilirubin: 6.9

Direct bilirubin: 2.85 










GENERAL EXAMINATION:-


Treatment - 


Dialysis started on 15/10/21 

Fluid restriction - < 1.5 litres/ day

Salt restriction - <2 g/day 

Tab . Lasix 40mg  BD 

Tab. Nodosis 500 mg BD 

Tab . Shelcal CT OD 

Tab BIO D3 0.24 mg OD

Tab .Orfer  XT OD

Tab . Erythromycin 4000IU /SC 

Cetrizine TID

Syp.Benadryl TID 



2/9/21 - 

Dialysis started on 15/10/21 

Fluid restriction - < 1.5 litres/ day

Salt restriction - <2 g/day 

Tab . Lasix 40mg  BD 

Tab. Nodosis 500 mg BD 

Tab . Shelcal CT OD 

Tab BIO D3 0.24 mg OD

Tab .Orfer  XT OD

Tab . Erythromycin 4000IU /SC 


 28/10/21


Tab . Lasix 40mg  BD 

Tab. Nodosis 500 mg BD 

Tab . Shelcal CT OD 

Tab BIO D3 0.24 mg OD

Tab .Orfer  XT OD

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