General Medicine Elog

Name - Sravani bekkam , Bhavya Ranjan 

Roll no. - 15,17

Semester - third 


    A CASE OF ANALGESIC NEPHROPATHY

This Eblog has been created under the guidance of  Dr MADHUMITHA BUDIGAM.

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


A 72 years old patient , who is a farmer , presented to the opd with chief complaints of -

1)On CKD, he has Analgesic nephropathy
2)hypertension (HTN) since 4 years
3)Underwent 4 sessions of HD(hemodialysis). 
4)Had h/O consuming NSAID 7yrs back intermittently . 


History of present illness -

The patient was apparently asymptomatic 7 years ago. He has a history of consuming NSAIDs since 7 years intermittently  because of which he developed chronic kidney disease for which he was on conservative management. He is a k/c/o hypertension since 4 years. He came to us on 19.06.2021 for AKI (secondary to GN) on CKD (Analgesic nephropathy). He Underwent 4 sessions of hemodialysis. 


Treatment History -

No Diabetes 
No CAD
Hypertension  since 4 years 
No asthma 
No Tuberculosis 
No Antibiotics 
No Hormones
No Blood transfusion
No Surgeries
No Radiation/Chemo

Personal History -

Married
Occupation- Farmer 
Normal Appetite 
Non vegetarian 
Regular Bowels
Normal Micturition
No allergies 
No addictions

General Examination  -

Patient is consious , coherent and cooperative. 
Pallor present
Icterus absent 
Clubbing of fingers/toes absent
Lymphadenopathy absent
Oedema absent
Malnutrition absent 
Mild dehydration 
Cyanosis absent

Systemic Examination-

Vitals - 
Pulse Rate- 83bpm
Bp- 120/60mmhg
Temperature- afebrile

CVS -
S1 and S2 heard 
No thrills
No cardiac murmur 
No focal deficits

RESPIRATORY SYSTEM:
NVBS 
BAE+
No cripts

PER ABDOMEN:-
shape of abdomen is Scaphoid
Tenderness not seen 
No palpable mass 
Bowel sounds are heard 
Liver and spleen are not palpable
No free fluid
No bruits
Normal hernial orifices 

CNS:-       
Patient is conscious. 
Speech is normal.
No signs of meningeal irritation. 
Reflexes are normal


DIAGNOSIS:-
CKD 2° to Analgesic Nephropathy on MHD
K/c/o HTN 


INVESTIGATIONS 

Serum iron 









Report






Treatment 

1. Tab. LASIX          40mg/PO/BD
2. Tab. NICARDIA   20mg/PO/BD
3. Tab. NODOSIS    550mg/PO/BD
4. Tab. OROFER. XT PO/BD
5. Tab. SHELCAR   500mg/PO/BD
6. Inj. ERYTHROPOETIN 4000 W/SC weekly once 


My queries 

1) What is the reason  for development of chronic kidney disease in a chronic NSAID user?
2) How Analgesic Nephropathy  developed  due to chronic kidney disease?


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