Case 7 POLYCYSTIC KIDNEY DISEASE

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A 55 Yr old male, granite cutter by occupation presented to opd with chief complaints of Swelling of both the feet and shortness of breath and lower bach ache since last 2 months. 

HISTORY PF PRESENT ILLNESS:

The Patient Was asymptomatic 3 months back then he developed "wet cough". ( on and off type) 

2 months back he developed shortness of breath while doing work. 

It was aggravated by work.

He also had pitting type of pedal oedema and facial puffiness  since 2 months. 

Then he went to a local hospital and used some medication but didn't have any prognosis.

PAST HISTORY: 

He got his right eye hit by a hard stone due to which he lost his  right eye vision permanently 8 months ago. 

He's not a known case of TB/ DM / ASTHMA / epilepsy. 

Personal history: 

Mixed diet 

-Reduced appetite 

Adequate sleep

-Irregular bowel movements 

Pt. has Burning micturition. 

Patient takes 100ml of alcohol and 4-5 bedis per day since 30 yrs.

FAMILY HISTORY : 

No known family history. 

GENERAL PHYSICAL EXAMINATION:

Patient is conscious, coherent, co-operative

Pallor -present

Cyanosis- absent 

Icterus- absent

Lymphadenopathy: absent

Oedema:pitting type of oedema present on both the feet.

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 murmurs.

CNS : 

Pt. was conscious, coherent and co-operative.  

Speech was normal. No slurred speech. 

Gait: normal. 

INVESTIGATIONS:

* Complete urine examination: No abnormality detected. 

* Ultrasound report: 

    Multiple cysts are found in kidney.

*COMPLETE BLOOD PICTURE:

*Random Blood sugar is within normal range. 

 108 mg/dl.

*Renal function tests:3/12/21

Highly elevated urea and creatinine. 

Calcium levels are decreased 

Phosphorous and sodium levels are increased.

*Liver function test: 

Elevated direct bilurubin and alkaline phosphate.

*ECG:

Provisional diagnosis: 

CRF-POLYCYSTIC KIDNEY DISEASE.

Treatment: 

Fluid and salt restriction.

T. Nodosis 500 mg BD 

T. Orofer xt PO BD 

Inj.erythropoetin 4000 IU weekly once.

T. Shelcal PO OD

Inj. thiamine 100 mg in 50 ml NS  I.V / TID 

T. Nicardia 20mg BD