A 55yr old male with Chronic kidney disease and Hypertension

A 55yr old male sandibatla

Chief complaints : complaining of Pedal edema  and shortness of breath since 10 days and fever since 15 days. 

HOPI: Pt was apparently asymptomatic 15 days back and then developed fever which was intermittent, not associated with chills and rigors.. relieving with medication.. After 4 days patient started developing pedal edema up to ankles,  which was progressive and Associated with Shortness of breath.. Then pt went to the local doctor where his creatinine was found to be 8.5 and patient was referred to kims for further evaluation. 

Past history : k/c/o DM and on Insulin Mixtard 20 and 15 units and 

K/C/O HTN since 5 years and on Atenolol 50 mg

 Personal history : 

PERSONAL HISTORY:

Mixed diet, Appetite normal, Occasionally  alcoholic and Smoking 3 beedis per day. 

No  other addictions.

GENERAL EXAMINATION:

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

Pallor present 

No icterus, clubbing, cynosis, lypmhadenopathy.

Bilateral pedal edema present. 

Anthropometry : 

Investigations: 

Rx: 

1) Ink. Lasix 40mg /IV /BD. 

2)Tab.Nicardia 10 mg /PO/ BD. 

3) inj. Human actrapid insulin /SC. 

4) tab. Nodosis 500mg PO/BD .

5) Tab. Shelcal CT-OD

6) Tab. Alfa D3/ PO/OD.

7) Tab. Orofer XT PO/OD.

8) Strict I/O charting.