55yr old male with CKD on MHD

A 55 year old from Aiti pamula who was a farmer came with C/o decreased urine output ,pedal edema,sob since 4 years
Patient was apparently asymptomatic 4 years back then he developed bilateral pedal oedema (pitting type), gradually progressive, a/w sob and h/o decreased urine output.
No h/o palpitations,burning micturition.
He was diagnosed with CKD and was undergoing 2 sessions of dialysis per week since 4 years because of which he stopped the agricultural work.
K/c/o HTN since 4 yrs -ON tablet Nicardia 10mg
Not a k/c/o DM,TB,ASTHMA, EPILEPSY,CAD.
No significant family history

ON EXAMINATION: PATIENT IS CONSCIOUS,COHERENT , COOPERATIVE.

Pallor- present
B/L Pedal edema (pitting type) present
No icterus, clubbing, cyanosis, koilonychia,generalised lymphadenopathy.


TEMP-AFEBRILE.
PR-83BPM
BP-120/80MMHG
RR-17CPM
SPO2-98
GRBS-121MG/DL
CVS-S1S2+
RS-BAE+,NVBS.
CNS-NAD
P/A- soft, non-tender,BS+

INVESTIGATIONS-
ON 22/12/2021
BLOOD UREA-79MG/DL
SERUM CREATININE-7.4MG/DL
SODIUM-148MEQ/L
POTASSIUM-3.9MEq/L
CHLORIDE-98mEq/L

SERUM IRON- 94ug/dl

HBsAg-negative
HIV-NON REACTIVE
HCV-NEGATIVE

BLOOD GROUP: "O" positive

CBP:

USG Abdomen:

PROVISIONAL DIAGNOSIS-
CKD ON MHD

TREATMENT-
1.FLUID RESTRICTION LESS THAN 2LIT /DAY
2.SALT RESTRICTION LESS THAN 2g/day
3.TAB.LASIX 40MG PO/BD
4.TAB.NICARDIA 10MG PO/BD
5.TAB.OROFER PO/OD
6.TAB.SHELCAL PO /OD
7.TAB.NODOSIS PO/BD
8.BP/PR/RR /TEMP 6TH HRLY ,I/O CHARTING.

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