A CASE PRESENTATION ON

CHRONIC KIDNEY
DISEASE
BY:
SALMA SHAHEEN
UNDER THE GUIDANCE OF
Mr. MOHD FAREEDULLAH
Associate professor
Pharmacy practice
INTRODUCTION
Chronic kidney disease (CKD) is a type of kidney disease in
which there is gradual loss of kidney function over a period of
months or years. Early on there are typically no
symptoms.Later, leg swelling, feeling tired, vomiting, loss of
appetite, or confusion may develop. Complications may
include heart disease, high blood pressure, bone disease,
or anemia
Causes of chronic kidney disease include diabetes, high blood
pressure, glomerulonephritis, and polycystic kidney
disease.Risk factors include a family history of the
condition. Diagnosis is generally by blood tests to measure
the glomerular filtration rate and urine tests to
measure albumin.Further tests such as an ultrasound or kidney
biopsy may be done to determine the underlying cause.
PATIENT DEMOGRAPHIC PROFILE
NAME: Mrs. moomeena
Age: 47 yrs SEX: F
UNIT: Nephrology
CHIEF COMPLAINTS: Decreased appetite since 1
month, nausea, vomiting, pedal edema since 5 days ,
sob on exertion, facial puffiness.
PMHx: type-2 Diabetes mellitus since 6 months, HTN
since 2yrs, CKD stage V
MEDICATION
S.N Brand Formu Generic Dose Route Frequency Indication
o name lation name

1. Pantop INJ Pantopraz 40mg IV OD acidity

ole
2. Zofer INJ Ondansetr 8mg IV TID Vomiting
on
3. Bio D3 plus Cap Vit D3 1 mg oral OD Vit D3
Deficiency
4. Amlogard tab Amlodipin 5mg oral OD HTN
e
5. Lasix INJ Furosemid 60mg IV BD Pedal
e edema
6. HAI INJ insulin As IV OD diabetes
per mellitus
scale
7. Ultracet TAB Tramadol 50mg oral BD fever
hydrochlor
ide and
acetamino
phen
PROVISIONAL DIAGNOSIS

CKD STAGE V
PHYSICAL EXAMINATION
O/E: C/C ,pallor, edema
Vitals : temp: 98.6 F, BP: 120/80mmHg, pulse:66b/min
CVS: S1 S2+
ADVERSE DRUG REACTIONS
S.No. Drug Reaction
1. Pantop Headache, diarrhea
2. Zofer Headache,constipation,
fatigue,fever,anxiety.
3. Bio d3 plus Headache, weakness,
thirst, debilitation ,sinus
bradycardia
4. Amlogard Palpitation,flushing,fluid
retenion
5. Lasix Dizziness,blurred vision
LAB INVESTIGATIONS
S.NO. INVESTIGATION RESULT NORMAL RANGE
1. Hgb 6.8gm/dl 11.0-17
2. RBC 2.4million/mcl 3.70-6.50
3. wbc 13.01/ml 4-11
4. platelet 150000 150000-450000
5. Albumin +ve 00
6. Pus cells 6-8pvf 0-4
7. Blood urea 14mmol/l 2.5-7.1mmol/l
8. Alkaline phosphatase 148 44-147UI/l
FINAL DIAGNOSIS
CHRONIC KIDNEY
DISEASE
DISCHARGE MEDICATIONS
Tab amlogard 5mg-bd
Cap bio D3plus-bd
Tab lasix 40mg-bd
Renal diet
HD weekly twice
SOAP
SUBJECTIVE:
A Female patient aged about 47 years has
been admitted in the nephro department for
the chief complaints of decreased appetite,
nausea,sob,pedal edema, facial puffiness
and severe azotaemia
The patient have a history of HTN and type
2 diabetes mellitus
OBJECTIVE DATA
The patient’s vitals are recorded as:
 Temperature :98 F
 BP: 150/90mmHg
 Pulse : 86b/min
 CVS: S1S2+
 P/A: soft
 CNS:NAD
ASSESSMENT
PROBLEM 1: decreased appetite
PROBLEM 2: vomiting
PROBLEM 3: pedal edema
PROBLEM 4: severe azotaemia
PROBLEM 5 :HTN
PROBLEM 6: type 2 DM
PROBLEM 7: abdominal pain
PLAN
P-1: decreased appetite
cap bio D3 Plus
P-2: vomiting
inj zofer
P-3: pedal edema
Inj lasix
P-4: severe azotaemia
Inj lasix
P-5: HTN
Tab amlogard
P-6: diabetes mellitus
Inj HAI
P-7: Abdominal pain
tab ultracet
PATIENT COUNSELLING
REGARDING MEDICATION:
Do not skip a dose of your medication.
Do not alter the frequency
REGARDING DISEASE
Chronic kidney disease is a condition in which the
kidneys lose some of their ability to remove waste
products and excess fluids from the blood stream.
REGARDING LIFESTYLE MODIFICATION
Have a diet rich in calories
Do regular exercise
Avoid salt and fluid intake