CKD on MHD

 39 yr/M with CKD

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 39 yr old male patient cane to opd with 

C/o pedal edema, shortness of breath and decreased urine output since 4 months.

He is undergoing sessions of hemodialysis and is under conservative management for 4 years .

Past history:—  k/c/o - htn since 4 months

           No k/c/o dm/asthma/thyroid/epilepsy.

Personal history :— 

Married

Diet- mixed

Appetite- normal

Sleep- inadequate

Bowel movements- regular

Bladder movements- decreased (decreased urine output)

Addictions:— smoking 🚬 (since 2yrs)

No known drug allergies.

Family history:— not significant

 General examination:—

—Patient is concious,coherent and cooperative.

No signs of pallor,icterus,cyanosis,clubbing,lymphadenopathy.

— pedal edema is seen.

Vitals:— 

    Temp:- afebrile

Pulserate:- 95/min

RR:— 95/min

Bp:— 160/90

SpO2:— 99%

Grbs:— 121%

 

Systemic examination:—

  CVS:— S1 and S2 heard, no murmers

  Rs :— BAE -normal

  Cns:- NAD

 PA :— abdomen is distended.

           Umbilical hernia is present.

           Fluid thrill - present

         

            

 Investigations:—

Urea levels— 56mg/dl

Creatinine— 5.3

IMG_3696.heic

USG:—-

  Ascitic fluid extending into umbilical hernial sac showing multiple internal septations.

IMG_3697.heic

Diagnosis:— CKD on MHD.

Plan :— 2-3 dialysis sessions per week.