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 an abdominal USG was ordered, it's findings were : 

•right small kidney with altered parenchyma ? Congenital 

•bilateral simple renal cysts.