52 yr old female with CKD

 52 Yr old female housewife by occupation presented to casualty for maintenance haemodialysis. 

Chief complaints::

Shortness of breath since 1 week

Pedal oedema since 1 week

Decreased urine output since 1 week.


History of presenting illness::

Pt. was asymptomatic 1 week back after which she developed shortness of breath and pedal oedema. Shortness of breath was aggravated by work.

No history of fever and vomiting. 


Past history: 

She is a known case of hypertension. 


PERSONAL HISTORY: 

Diet- mixed.

Appetite- reduced.

Sleep- adequate. 

Bowel and bladder- regular.

No addictions. 


FAMILY HISTORY: 

No significant family history. 


GENERAL EXAMINATION:: 




PALLOR- present. 

Pale conjunctiva. 

ICTERUS: Absent. 

Cyanosis: absent 

Lymphadenopathy: absent

  Oedema- absent. 


Vitals :- 


Temperature- Afebrile


Pulse rate- 72 beats per minute.


Respiratory rate- 20 breaths per minute. 


B.P - 140/70 mm hg


Spo2 - 99% at room air


Systemic examination: 


CVS:- S1 and S2 are heard,NO MURMUR


RS:- BAE+ , NVBS+


P/A SOFT ,NT


CNS : 


Pt. was conscious, coherent and co-operative.  


Speech was normal. No slurred speech. 


No meningeal signs.



- No abnormality detected. 


Reflexes: 

Right and left biceps, triceps, ankle and supinator show grade 2 reflex



Gait: Normal.


                              Investigations..

1. Colour doppler 2D echo: 

It shows - 

Sclerotic aortic valve

Dilated rt. atrium, rt. Ventricle, left atrium. 

Left ventricle - concentric left ventricular hypertrophy. 

Conclusion- moderate left ventricular dysfunction,  diastolic dysfunction. 


2. CUE, HEMOGRAM, LFT findings. 


3 Temperature recordings


4. TREATMENT HISTORY: 


ECG: 






Provisional diagnosis-

Chronic kidney disease. 









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