Dysfunctional bleeding (AUB _O) with deranged Kft

24 yr old female c/o heavy bleeding and irregular cycles.... Usg endometrial thickening.. Tranexamic acid.. Mefenamic acid given for three days and norethisterone 5 given for 3 cycles with cyclic withdrawal.. At first presentations severe anaemia Hb 4.7 gm% and creatine 1.7 mg/dl higher side transfusion of prbc and iron sucrose.. Al that worked for anaemia and bleeding.... But her kft deranged.. Now creatinine 2.8 mg/dl and blood urea 90 ...Hb 10 gm%.....

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Kindly do usg and see any stone or hydroureteronephrosis is present or not see there is any protein in urine or not even check her blood sugar hba1c and she is having any history of hypertension or not ??

Thank you doctor
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? DUB .. WITH..ANEMIA.. AND .. ELEVATED..LEVELS OF.. SR.. UREA .. SR.. CREATININE.. NEED'S CLINICOPATHOLOGICAL EVALUATION WITH.. HEMOGRAM.. HBA1C.. KFT.. LFT.. USG STUDY ABDOMEN..

Tnx
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Renal ultrasound to b done...it may be medical renal disease. Evaluate the cause such any nephrotoxic drugs she may be taking allopathic or homeopathic. Tk physician opinion

If usg shows endometrial thickening D&C required abd endometrium should be sent for HPE Present LFT and HB

Lft normal hb 10.... D&C and HPE was advised but patient and attendent refused tbat time..
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Adv diagnostic D and C, sample for HPE This will act as diagnostic and therapeutic

Dub ..with.. Anemia..and.. Renal disease..

USG to rule out renal parenchymal diseases

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