Factors influencing the decision of initiation of dialysis
Case 1: https://tejasree25.blogspot.com/2022/04/nephrotic-syndrome-with-type-i-dm.html This is a case of 22 year young married female with DM 1 since 11 years and Hypertension since 6 months 1st presentation : April 2022 Presenting complaints of B/L pedal edema since 1 months •Shortness of breath (grade 2-3 ) since 1 months,which is insidious on onset gradually progressive not associated with orthopnea /PND •Decreased urine output since 10 days •Swelling of lips since 3 days On examination Anasarca +, Pallor + Her baseline creatinine at time of admission was 4.7 , urea 82, serum albumin :2.8 , hb:7.8, Chest xray showing b/L moderate pleural effusion 2D echo : EF :60, good LV systolic function With severe metabolic acidosis ( anion gap :21 at admission , 8.2 at time of discharge ) Microvascular complications of diabeties + in this patient such as albuminuria, diabetic retinopathy changes 24 hours urinary protein 2.1 grams Fundoscopy : Diabetic retinopathy changes + We ma