CKD on Maintenance hemodialysis

“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 patient’s clinical problems with collective current best evidence based inputs. This e-log book reflects my patient centered online portfolio and your valuable inputs on the comments is welcome.”


A 65 year old male a farmer ,resident of bhongiri came to the opd 

CHIEF COMPLAINT

Dialysis(MHD) 

History of presenting illness
The patient was apparently asymptomatic 25 days back when he had complaints of shortness of breath, burning micturation, and 
And edema to a hospital in bhongiri where he was deemed as chronic kidney disease and was required to do dialysis
He came to our hospital for the dialysis
He had five dialysis till date
14 years ago he was in a RTA after which he had back pain 
He was apparently all these years till 25 days ago when he experienced severe shortness of breath and edema 

History of past illness
No history of Diabetes mellitus
                    Thyroid disease
                    Bronchial  Asthma
                    Tuberculosis
He is a hypertensive since 14 yrs

PERSONAL HISTORY

Married
Appetite-Decreased
non vegetarian
Bowels- decreased motility
Micturition- burning micturation
Addictions- occasional alcohol consumption and smoking but stopped 14 yrs back

FAMILY HISTORY

No significance


General examination

The patient is conscious coherent and cooperative

 Pallor is there

NO Icterus

NO Cyanosis

NO Koilonychia

NO Lymphadenopathy

PITTING TYPE OF EDEMA


NO Malnutrition

VITALS

 Afebrile


BP :140/90 mmHg 

Pulse rate : 99

Respiratory rate : 18

SPO2 at room air :99% 


SYSTEMIC EXAMINATION 

CVS

NO Thrills 
S1 and S2 heard +
NO murmurs
 

RESPIRATORY SYSTEM

Position of trachea: central
NO wheeze
NO dyspnoea

ABDOMEN

Shape : Scaphoid

NO Tenderness

No palpable mass, fluid , bruits


CNS 

Normal speech

NO signs of meningeal irritation

 DIAGNOSIS
CKD ON MHD


INVESTIGATIONS

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