A 39year old male patient with Renal AKI and polyarthritis
A 39year old male patient came to the opd with the chief complaints of fever since 5days which was high grade,persistent with pedal Edema and associated with chills and 2 to 3 episodes of loose stools.
Facial puffiness was present since 5 days .
Generalised body swelling (anasarca)since 3 days and associated with SOB.
H/o burning micturition since 5 days and decreased urine output since 5 days.
No H/O chest pain,pain abdomen ,vomitings.
Past illness-
-H/O polyarthralgia since 1year associated with swelling of joints (large+small-ankle,wrist,fingers,knee,shoulders)along with restriction of movements and also painful movements which decreased 8 months back but again increased since 3 months.
-No History of DM/HTN/Asthama/epilepsy/CAD/TB
Treatment history -not significant
Personal history-diet-mixed
-appetite -lost
-bowel and bladder movements -irregular
Addictions-none
Family history-Not significant
Vitals -
PR - 96
BP - 140/80 mmhg
RR - 16 cpm
GRBS - 131 mg/dl
Temperature- 102.1F
Spo2 - 97% at room air
General examination-
Patient is conscious, coherent and cooperative
No signs of pallor, icterus, cyanosis, clubbing and lymphadenopathy
Pedal Edema present
Systemic examination-
CVS- S1,S2 +, no murmurs
RS- BAE+
P/A- Soft, bowel sounds present
Tenderness + in the epigastrium and left hypochondrium
CNS-NAD
Investigations-
Diagnosis-
Renal AKI (?ATN) secondary to sepsis on CKD(Secondary to analgesic nephropathy) with symmetric polyarthritis under evaluation with hypervolemic hyponatremia.
Serum urea,creatinine and serum electrolytes
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