This document presents a case study of a 39-year-old male smoker who presented with puffiness of the eyelids and face, decreased urine output, and swollen lower limbs over the past 3 months. Initial investigations showed elevated creatinine and urea levels. A kidney ultrasound showed increased echogenicity and preserved corticomedullary differentiation of both kidneys. The patient was started on Lasix, potassium supplements, antibiotics, and albumin. A kidney biopsy was performed and the results are pending. The patient's creatinine and urea levels have further increased based on recent tests.
2. Personal history
Name : Mahmoud Mohammed Elsayed .Age
: 39 year Sex :male . Occupation : driver
.from Belqas
Marital status : single
Special habits : smoker about 20 cigarettes
/ day for 22year .addict on tramadol
3. complaint
Puffiness of eye lids and face
Decrease urine out put
Swollen of lower limb
Easy fatigability and increase body weight
4. Present histoy
Onset : the condition started since 3 months by
early morning puffiness of eye lid that improved
after few hours then gradually increased ‘presence
of lower limb edema ‘oliguria ‘elevated of blood
pressure
No history of DM or HTN
Investigations done at time of examination Cbc :
Hb 11.4 Tlc 14.7 Plt 555
8. Ultrasound of both kidney
Both kidney ; Average size
Increase echogenisity Grade II
Preserved corticomedullary
differentiation No stone No
back pressure
9. Past history
No history of HTN except during start
of illness NO history of DM
No history of other kidney disease
11. Plan
Start Lasix 40 mg / 8 h
Fluid chart UOP 6000 ml /24 h input
2000 ml
KCL Syp due to hypokalemia
Ceftriaxone 1 gm /24
Prepare patient for biopsy
12. Stop lasix and start aldactone 25 mg
Clexane 20 /24 h
Albumin bottle / 24 hour
Biopsy done and waiting for result