Ravali Irugurala

PRE FINAL OSCE LEARNING POINTS  05/12 /23  OSCE QUESTIONS :  1) Dialysis Disequilibrium syndrome?     Dialysis disequilibrium syndrome (DDS)   refers to an array of neurological           manifestations seen during or following   dialysis, primarily after the new initiation   of dialysis.However, it can also be seen in   chronic dialysis patients who miss their   regular dialysis treatments. This   syndrome is thought to arise from fluid   shifts during hemodialysis, causing   cerebral edema and a wide variety of   neurological symptoms. In continuous   renal replacement therapies (CRRT),   where fluid shift is limited, dialysis   disequilibrium syndrome is rarely     reported. The common risk factors that predispose a patient to dialysis dysequilibrium syndrome are  First hemodialysis treatment High blood urea nitrogen (BUN) (above 175 mg/dL or 60 mmol/L) before initiation of dialysis Extremes of age – children and elderly Sudden change in dialysis regimen Pre-existing neurological di

4-dec-2023 60 YEAR OLD MALE CKD ON MAINTENANCE HEMODIALYSIS WITH ANEMIA OF CHRONIC KIDNEY DISEASE WITH HYPERTENSION This is an a online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input A 60 year old male, who is a resident of Nalgonda ,farmer by occupation came with  Chief complaints : Pedal edema since 3 months. Shortness of breath since 20 days. Decreased urine output since 15 days. History of presenting illness: The patient was apparently asymptomatic 3 months back when he noticed bilateral pedal edema initially extending to ankle Gradually progressed up to thighs which worsened during last 15 days. Decreased urine output since 15 days, not associated with frequency, urgency burning