Case Study 3

 September 21, 2021

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September 21, 2021

A 50 year old woman labor by occupation presented to OPD for dialysis 

HISTORY OF PRESENT ILLNESS 

Patient was apparently asymptomatic 6 months back then she had shortness of breath with bilateral pedal edema along with decreased urine output and weakness and back ache then she stopped working . She also suffered from Inadequate sleep and loss of appetite . She took normal medication for 3 months and then consulted hospital in suryapet and khammam and she's sent to Kims for further treatment . Currently she's on dialysis from the past 3 months . She also have anemia diagnosed 3 months and she's on blood transfusions . 

PAST HISTORY 

She had 5 vaginal deliveries and tubectomised 30 years back . She's also diagnosed to be hypertensive 10 years back .

PERSONAL HISTORY 

Appetite - Normal 

Bowel and bladder movement - Normal

Sleep - Adequate 

Diet - Mixed 

No habitats of drinking and smoking 

FAMILY HISTORY 

No significant family history 

ON GENERAL EXAMINATION 

She was conscious, coherent and cooperative 

Pulse rate - 94 bpm

Blood pressure - 160/100 mmHg 

Respiratory Rate - 16 cpm

SpO2 - 98% at room air 

No Pallor, cyanosis , clubbing and lymphadenopathy 

Edema is present 

SYSTEMIC EXAMINATION 

CVS:

S1 S2 heard 

RESPIRATORY:

Bronchial artery embolism 

Normal breath sound is heard 

PER ABDOMEN:

Scaphoid 

No tenderness 

CNS:

No focal neurological deficits 

PROVISIONAL DIAGNOSIS 

Chronic kidney disease and on hemodialysis

Anemic 

Hypertensive since 10 years 

REPORTS 

ECG:

CBP:

Hemoglobin - 5.3 g/dl

TLC - 4200 cells/ cumm

Platelets - 1.5 Lakhs 

RENAL FUNCTIONAL TEST:

Urea - 5.1 

Creatinine - 3.5 

Sodium - 137

Potassium - 4.2 

Chloride - 104

TREATMENT:

Tab Lasix 40 mg/po/bd

Tab Nicardia retard 20 mg/po/bd

Tab shelchal 500 mg/po/bd

Tab Nododsis 500 mg/po/bd

Tab bio D3 0.25 mcg/po/bd 

Tab orofer xt po/bd

Monitor vitals 4th hourly 

Dialysis has been done weekly twice - 10 dialysis completed 

Inj.erythropoietin weekly twice 

Inj.iron sucrose 100 mg weekly twice

●Why's bilateral pedal edema is seen in ckd patient's ?

●Is there any relation between anemia and ckd if does then how ?