CHRONIC RENAL FAILURE SECONDARY TO T2 DIABETES AND HYPERTENSION.



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A 64yr old male presented to casualty with generalised oedema, decreased urine output, Shortness of breath since 10 days 

HOPI:

He was apparently assymptomatic 4 years back, had  history of pain abdomen and abdomen tightness and was brought to hospital, diagnosed with renal calculi and underwent PCN in our hospital and was discharged in 3-4 days 


Two years back he developed neck pain and generalised weakness and went for checkup for which he  was diagnosed to be diabetic and hypertensive and on irregular medication 


He had another admission around November of 2020 on being unresponsive and was in ICU for 4-5 days diagnosed to be hypoglycaemic and on OHA’s labs showing creatinine of 5.94 and was advised for dialysis and on refusing was discharged 


He had on and off pedal oedema with no history of decreased urine output, hematuria, frothy urine or lower urinary tract symptoms 


10 days back he had history of fever with loose stools with decreased urine output for one day and anuria for 3 days and was taken to local hospital and underwent 4 sessions of hemo dialysis ( creating 12.1 ) on economic constraints he was referred to our hospital for further management 

ADDICTIONS:

He has an occasional intake of alcohol( monthly once or twice ) and smokes tobacco pipe daily for the past 10-15 years 

GENERAL EXAMINATION:

On admission 

Pallor + 

Anasarca +

Pitting type 

No Icterus,cyanosis,clubbing and lymphadenopathy 

JVP:not elevated 












Bp : 150/80mmhg,in left arm in sleeping position 

PR:98bpm

RS:Bilateral air entry present

Normal vesicular breath sounds present 

Bilateral inspiratory crepts are present in basal areas 

CVS:S1 and S2 are present 

CNS:NAD

INVESTIGATIONS:


















 

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