A 45 years Old Male Patient With CKD On MHD

THIS IS AN ONLINE E LOGBOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS / HER /GUARDIAN'S SIGNED INFORMED CONSENT. HERE WE DISCUSS OUR INDIVIDUAL PATIENT'S PROBLEMS THROUGH A SERIES OF INPUTS FROM THE AVAILABLE GLOBAL ONLINE COMMUNITY OF EXPERTS WITH AN AIM TO SOLVE THOSE CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE-BASED INPUT 
 
CHEIF COMPLAINTS :-
Pedal edema,decreased urine output 
HISTORY OF PRESENT ILLNESS:-
HISTORY OF PAST ILLNESS:-
Chronic kidney disease on maintenance hemodialysis.
Diabetes mellitus since 15 years. 
Hypertension since 6 years. 
PERSONAL HISTORY:-
Appetite- normal 
Diet- nonveg
Bowels- regular 
Micturition- normal 
No known allergies 
No Addictions
FAMILY HISTORY :-
No significant family history. 
GENERAL EXAMINATION:-
No pallor, cyanosis, lymphadenopathy, icterus, clubbing of fingers and toes, malnutrition. 
Oedema of feet-(+ve)
VITALS:-
Temp-98°c/f
Pulse rate- 100/min
Respiratory rate- 18/min
BP-150/100mm Hg
Spo2-98%
GRBS-106 mg%
SYSTEMIC EXAMINATION:-
cvs- s1s2 Positive 
Respiratory system- BAE Positive, NVBS
Abdomen- shape is normal 
                 - no Tenderness 
                 - liver,spleen not palpable 
                 - Bowel sounds Positive
CNS- pt is concious 
        - no signs of meningeal irritation 
        -cranial nerves, motor system, sensory system are normal 
INVESTIGATIONS:-
ECG
DIAGNOSIS:-
CKD on MHD
DM
Hypertension 
TREATMENT :-
Tab Nicardia- 20 mg po/TID
Tab Arkamine- 0.1 mg po/BD
Tab Nodosis- 500 mg po/BD
Tab Shelcal po/OD
Cap BIO-D3 po/OD
Tab orofer-XT po/OD
Inj EPO - 4000 IV /SC weekly once 
Inj Iron sucrose 1amp+100 ml normal saline IV weekly once 
Inj HAI - SC /TID according to GRBS
Monitoring GRBS 6th hourly 


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