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70Y/M (CKD)

C/o pedal oedama since 6 months C/0 facial puffiness since 6 months C/o breathlessness since 6 months  C/0 abdominal distension 6 moths back.  History of Present illnesses :  Patient was apparently asymptomatic 6 months back, later he complained of  • Pedal Edema : insidious onset, gradual progression - Grade 2   -Pitting type    - Subsiding on medication (Lasix)   • Facial puffiness :   - Insidious onset, gradual progression, subsiding on taking medication   • Shortness of breath since 6 months:  - Grade 3 ~> 4 ( Progressed to grade 4 in the past few days)   - Orthopnea +   - no c/o PND, Palpitations, Chest pain.    •Abdominal distension : 6 months back  K/C/O Hypertension since 20 years. On medication ( Amlong 5 mg PO/OD)  K/C/O DM since 20 years, on insulin. Not a K/C/O TB, Asthma, CAD, Epilepsy  Patient was taken to Hyderabad for the following complaints, where ...

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