CKD

1. CHRONIC KIDNEY
DISEASE
WITH HYPERTENSION
AND TYPE II DIABETES

2. SUBJECTIVE EVIDENCE
 Swelling of both the
 lower limbs
 Exertional dysponea

3. OBJECTIVE EVIDENCE
Urea: 141mg/dl
Secr: 6.4 mg/dl(GFR 9.8)
Uric acid : 10.2 mg/dl
Hb: 7.6g
Albumin++
Pus cells 8-10
Total iron: 53mcg/dl(60-150)
TIBC: 214mcg/dl(250-450)
Unbounded IBC: 161mcg/dl(190-350)
Serum transferritin: 150mcg/dl(175-320)

4. ASSESSMENT
From the subjective and
objective evidence the
patient was diagnosed with
CKD,HYPERTENSION,DM
2.

5. PLANNING
 Relieve signs and symptoms.
 To start an effective therapy with minimal side effects
 To prevent progression of the disease
 To prevent further complications
 Replacement therapy-Dialysis, transplantation
 To improve HRQOL
 To maintain near normal Hb levels and to alleviate the
signs and symptoms of anemia

6. Treatment options
Primary prevention
Anti diabetics
Anti hypertensive's
Replacement therapy(Dialysis or
kidney transplantation)
Secondary prevention
Iron and vitamin supplement

7. Rx
Drugs Dose Route Frequency
Inj. Erythropoietin 4000 units SC For one week
T . Calcium carbonate 500mg PO 1-1-1
T . Prazocin 2.5mg PO 0-0-1
T . Calcium acetate PO 1-1-1
T. Torsemide 20mg PO 1-0-0
T. Atorvastatin 10mg PO 0-0-1
T . Sodium bicarbonate STAT 1-1-1
T . Aspirin 150mg PO 0-1-0
Cap. Alphacalcidol/ Calcitrol 0.25mg PO
T . Vit C+ Vit B3+ Vit B6+ folic
acid+ Pantothenic acid+ Vit B2 +
Vit B1 + Methylcobalamin +
Biotin
50mg+25m
g+10mg+10
mg+6mg+3
mg+2mg+5
00mcg+300
mcg
PO 0-1-0
Inj. Insulin 30/70 SC 6-0-0

8. PATIENT COUNSELLING
 High consumption of fruit, vegetables , cereals , legumes,
more fish, olive oil
 Review present blood pressure measurements and the
importance of blood pressure control in slowingthe
progression of CKD.
 use heart healthy diet to reduce further complication.
 Emphasize the need for compliance in diet and medication
 Adequate rest

9. THANK U