A 70 yr old man presented with shortness of breath, bilateral pedal edema and abdominal swelling with discomfort for last 4 years. He is unable to perform his daily routine due to the shortness of breath and complains of decreased urination. His sleep has been decreased and feels uncomfortable lying on his right lateral side.
He has a history of hypertension.
USG of the abdomen reveals slightly altered corticomedullary differentiation in renal parenchymal echotexture in both kidneys with a single cortical cyst in the left kidney, enlargement of median lobe of prostate, mild ascites and bilateral pleural effusion.
Echocardiography shows dilated cardiomyopathy with EF 20% and mild MR.
Blood examination reveals Hb 7.3, TLC 14800 with N89. Other biochemical examinations reveal urea 68.8, creatinine 1.7 (Ur/Cr 40.5), ALT 125, A;G ratio 1.06, normal thyroid function tests and PPBG 148.
Urine examination shows mild proteinuria, hematuria and presence of microorganisms, but pus cells 2-6/HPF.
ArogyaUDHC