CKD on MHD

This is an online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input.




This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome.



I have been given this case to solve in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with diagnosis and treatment plan.


Chief Complaints: A 15 year old male came to casualty with chief complaints of shortness of breath and bilateral pedal edema.

HOPI: 

Patient was apparently asymptomatic 2 months back. Then he had 2-3 episodes of vomitings daily associated with food particles not associated with blood. 

History of fever two months back associated with chills and relieved with medication.

C/o chest pain which is dragging type.

No H/o palpitations, Syncope attack,

no pedal edema 

no facial puffiness

 no h/o decreased urine output.


Then he was diagnosed with CKD as his serum creatinine was 13.5mg/dl. He was on dialysis 4 times a week while he was in a hospital at Hyderabad.

Later he came to Nalgonda where he was on Dialysis 3 times a week. After 5th dialysis he developed SOB (grade 2-3) and chest pain. Then he was shifted to our hospital. Here he was on dialysis since one month ( 3/7).

Past History: Hypertension since 2 months.

Family History: Hypertension is present.

Personal history:

Appetite- Normal 

Diet - Mixed 

Bowel and Bladder - Regular 

Addictions- No

General Examination:

Patient is conscious coherent and cooperative Pallor- yes

No cyanosis, Icterus, lymphadenopathy, oedema, clubbing, malnutrition.





GCS : 15/15

Temp: afebrile

PR- 82 BPM

RR- 25 CPM

SPO2 - 96

BP- 130/90


Systemic Examination:

RS: NVBS

CVS - S1 &S2 +

P/A - soft and non tender 

CNS- NAD

Investigations:








Provisional Diagnosis- CKD on MHD.

Treatment:









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