A69 YR OLD MALE WITH BILATERAL HYDROURETERO NEPHROSIS AND AKI ON CKD


Name : Y.Navya Sahithi Reddy
Roll no: 146

THIS IS AN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE - IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS / HER /GUARDIAN'S SIGNED INFORMED CONSENT .HERE WE DISCUSS OUR INDIVIDUAL PATIENT'S PROBLEMS THROUGH SERIES OF INPUTS FROM AVAILABLE GLOBAL ONLINE COMMUNITY OF EXPERTS WITH AN AIM TO SOLVE THOSE CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE BASED INPUT .

A 69 year old male who is farmer by occupation came to the opd with cheif complaints of 
B/L pedal edema present since 15 days
Poor urine stream
Nocturia positive with 5-6 times 
Burning micturation since 15days
Itching all over the body since 7 days
Increased frequency with urgency 10 -15 times per day
HOPI : 
patient was apparently asymptomatic 15 days back and later he developed bilateral pedal pitting type of edema since 15 days and buring micturition .There is increased frequency of urination i.e; 10 to 15times per day and nocturia with 5 to 6 times at night.
Past history: 
Patient had chronic eczema over right lower limb with uremic pruritis and generalised xerosis for which he was using liquid parafin and diphenaramine hydrochloride tablets.
He was not a known case of DM,HTN,ASThma.
Personal history:
Diet : Mixed diet
Sleep : disturbed because of nocturia with a frequency of 5 to 6 times
Bowel movemnts are regular
Bladder movements had increased frequency of micturition and urgency with 10 to 15times per day.
Addictions : occasional drinker
GENERAL EXAMINATION :patient was consious cooperative and well oriented to time and space.
PALLOR : no
Icterus : no
Lymphadenopathy : No
Clubbing " no
Edema : yes bilateral
 Temp: 98 F
Respiratory rate : 16 cpm
Pulse rate: 82bpm
Bp : 110 /80 mm of hg
Spo2 : 92 at room pressure.
Systemic examination:
CVS : no murmurs heard, s1 and s2 heard
Respiration :no dyspnea  and vesicular breath sounds are heard.
Abdomen :
Normal.
But itching over the upper abdomen
CNS : normal reflxes and intact senses.
SKIN: chronic exzema with genralized xerosis on right lower limb
RFT:
serum creatinine:
CUE:
hemogram:
CBP:
LfT:
blood urea:
CT KUB :

usg of bladder
PROVISIONAL DIAGNOSIS:
a patient developed AKI on CKD with bilateral hydrouretero nephrosis.
TREATMENT:

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