case 19

52year old male
DOA -3/11/2023
DOD -10/11l2023

Diagnosis 
CKD -POLYCYSTIC KIDNEY DISEASE.



 Case History and Clinical Findings-

PATIENT IS KNOWN CASE OF CKD SINCE 5 YEARS ON CONSERVATIVE MANAGEMENT HISTORY OF PRESENTING ILLNESS-PATIENT WAS APPERENTLY ASYMPTOMATIC 5YEARS BACK THEN HE DEVELOPED EPISODE OF VOMITIG,DECREASED APPETITE FOR WHICH HE CONSULTED LOCAL HOSPITAL AND WAS DIAGNOSED AS CKD AND WAS UT ON CONSERVATIVE MANAGEMENT.
PATIENT HAVE CHIEF COMPLAINTS OF SWELLING OF BILATERAL LOWER LIMBS SINCE 5 DAYS
SWLLING EXTENDING UPTO KNEES AND PITTING TYPE OF EDEMA AND RECLINED TO SOME EXTENT ON LYING DOWN CHIEF COMPLAINTS SOB
CHIEF COMPLAINTS OF DECREASED URINE OUTPUT SINCE 10 DAYS C/O DECREASED APPETITE,NAUSEA

PAST HISTORY -
K/C/CO HTN SINCE 10 YRS
NOT A K/C/O/ DM,EPILEPSY,TB.THYROID DISORDERS,ASTHMA.

 PERSONAL HISTORY : 
DIET :MIXED 
APPETITE : LOST 
SLEEP : ADEQUATE
BOWEL:REGULAR
ADDICTION HISTORY
ALCOHOL STOPPED 19 YEARS BACK.


GENERAL EXAMINATION : PATIENT IS CONSCIOUS , COHERENT , COOPERATIVE
PALOR -NO
PEDAL EDEMA -NO
NO SIGNS OF CLUBBING , ICTERUS , CYANOSIS , LYMPHEDNOPATHY
VITALS :
TEMP : 98.3 F
PR : 88 BPM
BP : 140/80 MMHG
SPO2 : 94%
RR : 20 CPM
SYSTEMIC EXAMINATION :
CVS : S1 , S2 HEARD , NO MURMURS
RS : BAE + , NVBSHEARD
PA :SOFT,NT, NO ORGANOMEGALY
CNS : NFAD
Investigation
CBP 
HB7.5 
MCV-80.2
MCH-28.8
MCHC -31.2
TC 5400 
PLT 1.2 

S.iron-34
S.ferritin-210.4

SMEAR NORMOCYTIC NORMOCHROMIC ANEMIA WITH MILD
THROMBOCYTOPENIA 

HIV NEGATIVE 
HBSAG NEGATIVE 
HCV NEGATIVE

RFT 
UREA-83 mg/dl
CREATININE-8.4 mg/dl
URIC ACID-4.5 mg/dl
CALCIUM-9.1 mg/dl
PHOSPHOROUS-3.7 mg/dl
SODIUM-140 mEq/L
POTASSIUM-4.4 mEq/L
CHLORIDE-105 mEq/L.

2D ECHO - EF:50% ,
MILD TR+ WITH PAH/ MODERATE AR+ , TRIVIAL MR+ , NO RWMA . NO AS/MS , SCLEROTIC AV , FAIR LV FUNCTION, CONCENTRIC LVH + , GRADE I DIASTOLIC DYSFUNCTION +, NO PE USG ABDOMEN :
B/L POLYCYSTIC KIDNEYS WITH GRADE III RPD

INTERVENTIONS
ORAL IRON THERAPY -DAILY TAB.OROFER XT
IV IRON THERAPY -TWICE /WEEK
EPO -YES
EPO DOSING -ONCE/WEEKS
PRBC TRANSFUSED -0
ADMISSION IN ICU -0



Treatment Given(Enter only Generic Name) TAB.TELMA 80 MG OD .
TAB LASIX 80MG PO/BD 
TAB. NICARDIA 20 MG PO/TID
 TAB SHELCAL 500MG PO/OD 
CAP.BIO D3 ONCE A WEEK
 TAB OROFER-XT PO OD 
INJ.EP0 4000 IU SC WEEKLY ONCE 
INJ.IRON SUCROSE 1AMP IN 100ML NS IV /OD
In ALTERNATE DAY.

Advice at Discharge 
TAB.TELMA 80 MG OD 
TAB LASIX 80MG PO/BD 
TAB. NICARDIA 20 MG PO/TID
 TAB SHELCAL 500MG PO/OD 
CAP.BIO D3 ONCE A WEEK 
TAB OROFER-XT PO OD
INJ.EP0 4000 IU SC WEEKLY ONCE 
INJ.IRON SUCROSE 1AMP IN 100ML NS IV /OD
ALTERNATE Day.

HB at the end of 3months 
HB-7.7
MCV-79.5
MCH-28.7
MCHC-30.7
TLC -6900
PLT-2.0

HB AT THE END OF THESIS 
HB-7.6
MCV-78.4
MCH-27.9
MCHC-30.6
TLC -7200
PLT-2.14

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