Concluded Case

Diabetic nephropathy with CLD

Patient complaints of headache, maturation Swelling over body, anemia, anorexia, irritable K/c/o DM,HTN Chief Complaints Headache Maturation of urine Swelling over the body Fatigue, generalized waekness Hyperglycemia History DM HTN Medium economic data Vitals B.P 190/100 HR 109 RR 24 Spo2 96% Physical Examination Pitting edema both limbs Diagnosis Diabetic nephropathy with UTI,CLD Management Patient on medical management Please suggest further management and diagnosis and prognosis

LikeAnswersShare
Concluded answer

Going through the case history and investigations It is a c/o chronic renal failure bcz of DKD Mild BPH is responsible for retention urine Mild cholecystitis or psuedothickening of GB walls CLD with PH and ascitis Kco diabetes and hypertension C /o headache and swelling over body with fatigue and gen weakness and hyperglycemia He is a c/o decompensated heart failure as seen from xray chest and ecg Xray chest suggest cardiomegaly with PAH Secondary to PH and CLD Yes for all this status responsible for DKD as albuminurea and reverse a/g ratio suggest hypoproteinemia and pt has ascitis Rx diuretics with i/o observation Put him on catheter Treat PAH inj pentoxyphyone Improve cardiac output So far CLD and DKD is concerned we need to look for DKA Inj sodabicarb to correct metabolic acidosis Bph too require attention as retention quantity is to be calculated Sos dialysis is to be considered Hba1c is varied abd eAG is not sugnificant still insulin is to be considered plain nph may be started Broadspectrum antibiotics Balance the electrolyte imbalance

All Answers

Going through the case history and investigations It is a c/o chronic renal failure bcz of DKD Mild BPH is responsible for retention urine Mild cholecystitis or psuedothickening of GB walls CLD with PH and ascitis Kco diabetes and hypertension C /o headache and swelling over body with fatigue and gen weakness and hyperglycemia He is a c/o decompensated heart failure as seen from xray chest and ecg Xray chest suggest cardiomegaly with PAH Secondary to PH and CLD Yes for all this status responsible for DKD as albuminurea and reverse a/g ratio suggest hypoproteinemia and pt has ascitis Rx diuretics with i/o observation Put him on catheter Treat PAH inj pentoxyphyone Improve cardiac output So far CLD and DKD is concerned we need to look for DKA Inj sodabicarb to correct metabolic acidosis Bph too require attention as retention quantity is to be calculated Sos dialysis is to be considered Hba1c is varied abd eAG is not sugnificant still insulin is to be considered plain nph may be started Broadspectrum antibiotics Balance the electrolyte imbalance

Thanks sir
0

View 1 other reply

Diabetic nephropathy ,CKD, Renal anemia Cirrhosis of liver with portal hypertension. BPH HTN Cardiomegaly , ECG , wrong limb lead placement, low voltage complexes Fluid overload state , cardiac failure ( Kerle B lines, fissural effusion ) Suggest Insulin for sugar control, watch for hypoglycemia Treatment of UTI and CKD Treatment of cirrhosis liver with combination of loop and K sparing diuretics. Careful Albumin infusions Antibiotics for UTI Investigations of anemia, may require Erythropoietin injection . Upper GI endoscopy to rule out bleeding oesophageal varices

Thanks sir
0

View 2 other replies

? DIBETIC NEPHROPATHY.. WITH.. BRONCHITIS.. NEED'S TO..R/O..COVID-19.. STRICT GLYCEMIC CONTROL WITH ANTIDIABETIC MANAGEMENT AS WELL.. MANAGEMENT FOR ..NEPHROPATHY..

Tnx Dr Shivraj Agarwal sir
0

1.Decompensated chronic liver disease with portal hypertension and mild -mod ascites with AKI--- GRADE 2 HEPATIC ENCEPHALOPATHY 2.Diabetic nephropathy 3.UTI 4. FLUID OVERLOAD 5.ANEMIA TREATMENT. 1. get 2d echo done check for EF % check for urine output plan for hemodialysis if. required 2.start on IV broad spectrum antibiotics 3.check for electrolytes 4.check for se.ammonia 5. lactulose syrup hs POOR PROGNOSIS

Thank you doctor
0

Acute Bronchitis Diabetic nephropathy  1): If patient on insulin then proper dose regulation and monitoring of sugar levels is required in consultation with Diabetologist. 2): Ashwagandha + bala moola+ madhumehantak+ tejovatyadi+ manjistadi+ sudh shilajeet+ udumbar ghan satva: 2 tsp BD A/F 3): Vasantkusmakar ras+ ekangveer ras+ CPV: 1 each BD B/F 4): Udvartanam with vacha churan or manjistadi churan. 5): Dhanyamala dhara. 6): Regular kati exercise to ensure proper blood circulation.

Cases that would interest you