A 22yr female with CKD ON MHD

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History was given by the parents and patient.

History and HOPI: (History started 5months back- from October 2020)

 A 22 year female, resident of nellagudam(1hr from miryalaguda) who is a student by occupation finished her degree in MPC( maths,physics and chemistry) and being interested in physics ,she wanted to pursue her Post graduation from Physics ,and was preparing for PG admission exam. 5 days before the exam, she started experiencing heavy menstrual bleed , so she went to RMP and took some medication and got relieved, following next day she started developing blurring of vision,which was not progressive and present throughout the day. At the same time ,her grand mother expired and she was not able to visit the ophthalmologist and after 2-3 days ,she visited ophthalmologist, who said she had swelling of the veins in the eye,water accumulation in the eye and anamia also,and  asked the parents to visit the specialist in Hyderabad..But the patients went to Guntur , because they had a family doctor in guntur. The patient visited the ophthalmologist in guntur where the treatimg doctor could not understand what had happened in her eyes . In the mean time the doctor checked her BP around 2-3 times  , where he found it was around 220/100mmhg..so the patient was taken to general physician beside the same hospital , where the treating physician observed her urea and creatinine levels are high ( around 16).. Immediately the next day ,central line was placed and patient was planned for fistula and she has taken dialysis in guntur for 2 months and her blurring of vision was reduced ..Being nearer to home she was brought to Kim's for further workup and dialysis.

Past history: 

No H/0 of similar complaints in the past.

 No H/o of DM,HTN, CVA,CAD ,TB, ASTHMA.

Personal history : 

PERSONAL HISTORY:

Mixed diet, Appetite normal,

No  other addictions.

Menstrual history: 

Cycles are regular , 3/28 and changes 3 pada per day. No H/0 passage of clots.

GENERAL EXAMINATION:

Patient was consious, coherent, cooperative;oriented to time,place,person.

Pallor present 

No icterus, clubbing, cynosis, lypmhadenopathy, pedal edema.

Treatment given: 

1) Inj. Lasix 40mg /IV /BD. 

2)Tab.nifedipine 10 mg /PO/ TID

3) tab. Nodosis 500mg PO/TID .

4) Tab. Shelcal CT 500mg/OD

5) Tab. Alfa D3/ PO/OD.

6) Tab. Orofer XT PO/OD.

7) Inj.Erythropoietin 4000IU /SC,weekly twice.

8) Tab.Alpha D3 PO/OD.