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?

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? RENAL PATHOLOGY WITH.. ANEMIA.. HT.. NEED'S.. ANEMIA PROFILE.. HEMOGRAM.. KFT .. ACR .. GFR ..

Tnx &wc Dr Ajeet Singh
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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

Immediate 2 unit PRBC TRANSFUSION after blood samples are taken
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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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