Please suggest essential treatment and management

54Years, female house wife suffering from HTN, HYPOTHYROIDISM since 6 years. Chief Complaints Puffy face, padel oedema, dyspnoea when walking Or if any work. History Sodium and potassium, urea, creatinine gradually increase haemoglobin decrease with in January 2020 to nowadays. Vitals BP 150/90 mm/ hg Puls 86 bpm SpO2 96% Physical Examination Severe anaemia seen , puffy face, padel oedema, Investigations Report on 11/05/20 Hb% 8•2 Urea 45 Creatinine 4 Sodium 136 Potassium 3•5 Current report tag below. Diagnosis Please suggest??? Management Medication... Cap. Pantoprazole + Domperidone (40+30) BBF Tab. Stamlobeta ABF Tab. Lasix 40 mg BDPC Cap. Autrin ODPC Tab. Thyrox 100 ODAC If any medication please suggest

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Very high creatinine 8.81 mg/dl with complains of breathlessness It is suggestive of end stage renal disease with fluid overload This patient is in need of urgent dialysis Anemia is likely to be secondary to renal failure, this patient may need Inj. Erythropoietin for correction of anemia

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No latest TFT are available Report posted shows abnormaly high sr creatinine and blood urea with Na 156 is hypernatrimia with hyperkalamia Severely anaemic All findings suggest ESRD and pt needs to be on dialysis and further workout Pt is diabetic or it is hypertensive renal disease As pt is in CRF hence all these reflections of anaemia electrolyte imbalance overload Needs 2decho ecg usg abdomen To be managed further as per response to dialysis

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HYPOTHYROIDISM.. HT .. ANEMIA..WITH.. RENAL FAILURE.. NEED'S.. HOSPITALIZATION AND.. DIALYSIS.. BS..ANTIBIOTICS.. DIURETICS.. ANTIHYPERTENSIVE AS PER REQUIREMENT.. ERYTHROPOIETIN.. BT ..SOS.. TFT.. WITH.. ENDOCRINOLOGIST OPINION.. AVOID.. CO-ADMINISTRATION OF .. THYROX AND.. ANTIHYPERTENSIVE DRUGS..AS WELL HEMATINIC'S.. BETTER TO TAKE.. THYROX ..AT BEDTIME.. FOR BEST RESULTS..

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CKD.Give blood transfusion,inj erythropoitin,tab calcium.Adv TFT.Persistent Failure despite diuretics and correcting hb will be indication of dialysis.Also treat hyperkalemia

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Pt is now CRF Grf pt will require dialysis Hyperkaelemia Hypernatremia GFR

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CRF. Refer to nephrologist

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Pcv insted of BT

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Renal failure.Nephrologist opinion and further management needed

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ESRD......anemia

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