Chronic Kidney Disease
65 year old female Known case of HTN uncontrolled S.Cr - 2.52 Hb - 7 TLC - WNL BUN: Cr - >20:1, which points towards pre renal as the cause Given a dose of Darbopoeitin 40 mcg but no elevation in Hb even after a week She was on Cilnidipine 10 + Metoprolol 25 + CH 12.5 in morning, Cilnidipine 10 in night + Moxonidine 0.2mg BD Her BP is still uncontrolled in range of 150 to 160/ 90 to 100 and his S. Cr raised again from 1.5 to 2.52 Urine R,M report awaited Which anti hypertensives would be safest in such kind of patient?
? RENAL PATHOLOGY WITH.. ANEMIA.. HT.. NEED'S.. ANEMIA PROFILE.. HEMOGRAM.. KFT .. ACR .. GFR ..
For CKD pts BP b/w 150-160 is not a matter of concern as already end organ damage has occured.adv fundus examination.also we can add tab arkamine 0.2 mg tds with above regime
Adv: IRON PROFILE, Comment on peripheral smear, KFT, ACR, eGFR, LIPID PROFILE, FBS Is there any h/o hemorroids or chronic blood loss Avoid protein rich diet Tab TORSEMIDE 10mg od Tab NEFROSAVE FORTE od Tab SHELCAL XT od Tab FERONIA XT od Continue rest medication
CKD WITH ANAEMIA If not responding to given treatment i will shift on ACE/ARB Azilsartan and diuretic dytor Or try ARNI Anaemia may need BT
CKD punarnavadi guggul gkshuradi guggul dashmularishta panchkolasava r some preparations which showa little bit improvement
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