40 year old male with CKD

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Complaints: 

Patient was on maintaining hemodialysis in outside hospital and want to continue hemodialysis in kims institute , so referred here.

History of present illness : 

Patient was student in osmania university,LLB student and also used to prepare for competitive examination and  apparently asymptomatic at 17 years of age , patient had weakness of the both lower limbs , visited multiple hospitals ,but it was not cured and patient was suggested to use ayurvedic medication , which improved his weakness. At 28years of age, then developed Head ache which was gradually progressive and not relieved with any medication and went to doctor and found his blood pressure was high and started on antihypertensives.Patient used to visit multiple doctors, because of uncontrolled blood pressure.

At around 35 years of age , patient developed multiple episodes of vomtings and used to sleep in the office ( patient was unaware that he was sleeping ),visited doctor, where his renal parameters was deranged and started on hemodialysis outside hospital and continued for 5 years.

At around 40 years of age (20 days back): patient was driving the bike along with his nephew and had skid and fall from bike and injury to the right hip and underwent Total hip replacement in outside hospital.

6 days back : patient had h/o of fall ,while walking along with the helper in to the dialysis room and had developed left medial condyle fracture.

Provisional diagnosis: Chronic kidney disease on maintenance hemodialysis with known case of Hypertension.