A 39 year old male with Hypertension and Chronic kidney disease.

Chief complaints : A 39 yr old male resident of miryalaguda ,agriculture by Occupation complaining of Pedal edema and shortness of breath since 3 month along with decreased Urine output. 

HOPI : Pt was apparently asymptomatic 3 months back then developed Pedal edema Grade 2 and shortness of breath for which he went to the local doctor where he was diagnosed with CKD and Hypertension ( Records not available) .For which he was started on medical management.. In spite of failure of the medical management he was Referred to kims for further evaluation... 

Past History :

1) Hypertension since 3 months and using 

2) laproscopic surgery in view of Intestinal obstruction??? 6 years back( No records) 

Personal examination: 

Mixed diet 

Appetite normal 

Alcohol intake : since 20years ..daily up to 180ml and  and non smoker 

Generalized  examination :pt is c/c/c ,oriented to to time, place, person. 

Pallor present 

No icterus, clubbing, cynosis, lypmhadenopathy.

Bilateral pedal edema present. 

Abdominal girth : 

Anthropometry:

Diagnosis : Chronic kidney with hypertension on Maintainence hemodialysis. 

Treatment : 

1) Fluid and Salt restriction. 

2) T. Clinidipine 10mg / PO / BD

3) T. lasix 40 mg/ PO/ BD. 

4) T. Arkamine 0.1mg / PO / TID

5) T. Telma -H / PO/BD .

6) T. Orofer XT PO/OD 

7) T. Shelcal-CT PO /OD

8) T. BioD3 PO / OD

9) T. Nodosis 500mg / BD.