37yf VH done 3yr back P3L3 c/o weakness, loss of appetite, hyperacidity vth regurgitation, low backache..BP-140/100.no H/O DM.HTN.thyroid.scd.her hb- 6.6gm, urea-88,creat-3 .plz help further ix n mgt



Kindly look for Mixed connective tissue disorders also proceed for a usg abdo for kidney size since there is no proteinuria there are less chances of diabetic nephropathy urine routine also shows pus cells 2-4 cells/hpf,kindly investigate further n treat accordingly Send serum calcium serum phosphorus serum uric acid.. Also we cant ignore the triad of HTN,Anaemia,deranged urea n creat points towards Ckd If usg abdo pelvis shows normal kidney size need to evaluate further with renal biopsy

Gastritis with CKDwith mild hypertensive may because of ckd usg kub rft GFR hco3 no NSAIDs safe tramadol50 tds ppi no antacid spicy less tea less 1 hr sitting after meal try sodamint amlodipine or lisonoppril less salt water 11/2 litreper day

chronic renal disease,, need further workup including CT kub, gfr,, most important timely nephrologist opnion

looks like C/o CKD,further check for electrolytes if sr pot is high needs dialysis,and ABG for acidosis otherwise plan for CT kub,for parenchymal changes on kidney, refer to nephrologist for renal biopsy

microcytic anisocytosis .seen in chronic kidney disease. may need further evuluation

Ultrasound abd followed by CT Abdomen if some suspicion. Looks a case of CKD but malignancy is also to be ruled out.Do CA 125 also

USG to rule out any malignancy mainly ovaries as renal function is impaired might be because of pressure .

Dear Doctor..as i am looking at this case with the history provided ..i understand that the pt is complaining of weakness and lethargy..loss of appetite.. all of which is being explained by anemia..and her KFT is deranged..now to get further what i would have done is to look for any findings in general physical examination.. are there any relevant finding..then what is the GBP ..is it microcytic hypochromic picture..that makes it iron deficiency or is it normocytic normochromic..like in the anemia of chronic disease..further get USG whole abdomen done..look for kidney size..ask for the urine output..

Anaemia, BUN Increased Go for USG to see Renal status possibility.of CKD

look for hyatus hernia for h.acidity and regurgi

Anaemia, advised PCV transfusion & KFT.

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