A 60 yr old female with chronic kidney disease and. HTN

 A 60 yrs female who was labourer by occupation  came with c/o pedal oedema since 1week and sob since 1week 

HOPI : Pt was apparently asymptomatic 5yrs back then developed generalized weakness along  with pain in the joints which made her to stop going to the work followed by which after 6months Pt developed fever with vomitings and generalized weakness and pt went to the local hospital from which she was referred to hyderabad in view of kidney pathology (exact pathology and the reason for pathology not known and records not available) then Pt had consultation with nephrologist for about 2yrs , where conservative  management was given.

The nephrologist has advised the admission but the Pt refused because of unoffordability and the Pt came to Kim's for further evaluation  2yrs back from that time she was on the maintenance hemodialysis 

Past history :

H/o fracture at the left wrist joint 10 yrs back and fracture of right wrist 5yrs back both are due to h/o fall 

K/c diabetes since 5yrs (she was on irregular medication and medication records not available) 

K/c HTN since 5yrs (Pt was using medication while she was admitted in the hospital, she wasn't using medication at home )

Personal history :

Mixed diet 

Appetite normal 

Non alcoholic and non smoker 

H/o beta leaf chewing with areca nut since 30yrs and stopped 5yrs back. 

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

Pallor present 

No icterus, clubbing, cynosis, lypmhadenopathy.

Bilateral pedal edema present. 





Vitals :

Pt is afebrile

Bp :160/90 mmhg

PR: 72bpm

RR: 30c/m


Anthropometry :


Truncal obesity present 



Systemic  examination:

CVS : S1s2 heard

R/S : BAE present 

Treatment :

Tab nicardia 2OMG Po Bd

Ink lasix 40 mg iv bd

Tab Nodosis 550mg bd

Tab shellcal -CT po bd

Tab D3 Po bd

Tab Orofer XT po od

Fluid restriction less than 1.5L/D

Salt restriction less than 2gm/day







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