Diabetic nephropathy

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N Akshaya

Roll no 197

A 62 year old female , farmer by occupation came to opd with chief complaints of nausea and vomiting since 10 days , fever.

History of presenting illness:

Patient was apparently asymptomatic 6 months back then one month ago she developed pedal oedema bilaterally , insidious in onset , gradual in progressive , bilateral pitting edema extended to knees.

Past history

No h/o shortness of breath

No h/o similar complaints in the past 

H/o diabetes since 10 years 

Family history 

No h/o  asthma, tb , hypertension,heart disease,asthma , cancer.

No significant family history 

Personal history 

Sleep : normal 

Appetite : decreased 

Diet : mixed 

Bowel and bladder movements : regular 

Micturition : normal 

No known allergies

GENERAL EXAMINATION: 

pallor : yes 

No cyanosis , clubbing , icterus , lymphadenopathy 

Malnourished 

Oedema of feet is present .

Vitals:

Temp .a febrile 

BP : 150/80mmhg

Pr:90bpm

RR: 16cpm

Spo2:97% 

SYSTEMIC EXAMINATION:

CVS : S1,S2 heard

RS : BAE present

INVESTIGATIONS:

Urea 73mg/dl 

Creatinine 1.4mg/dl

Uric acid: 6.4mg/dl

Rbs: 153mg/dl

Hemoglobin : 6.6gm/dl

DIAGNOSIS : DIABETIC NEPHROPATHY with severe anemia .

Treatment : 

Fluid restriction 

Salt restriction 

Tab lasix 40mg bd

Tab orofer od 

Inj erythropoietin 

Tab nodosis 500mg bd 

Hemodialysis

Follow up :

 

Day 1 :

swelling not reduced ,dialysis is done.