58yrs old male with CKD on MHD
58 year old male, labourer by occupation, came to the OPD with the chief complaints of Shortness of breath since 15 days, worsened 3 days back, facial puffiness since 1 week History of Presenting illness - Patient was apparently asymptomatic 4 years ago 4 years ago - pt complained of giddiness, went to a local hospital and was diagnosed as Hypertensive, on regular medication since then T. Nicardia 10mg, T. Arkamine 0.1mg sos 2 years back Pt developed B/L pedal edema, progressed gradually to knees, diagnosed with renal failure and initiated dialysis weekly twice Left upper limb swelling, gradually progressing to current size, since 4 months . Swelling in the left chest region, gradually progressing to current size, since 4 months Back pain since 2 months, subsided on medication (T. Ultracet) 7 days back - developed Facial puffiness Shortness of breath since 7days Grade II-III progressed to Grade IV since 15 days along with orthopnea No c/o palpitations, cold, cough, burning micturitio