A case report on management of chronic renal failure

Abstract

ABSTRACTChronic kidney disease may result from a primary intrinsic kidney disease, from anatomic or obstructive abnormalities, as a secondary complication of another systemic disease, or from acute kidney failure that never fully resolves. The major diseases that lead to chronic kidney failure and new cases of ESKD are diabetes, hypertension, and glomerulonephritis. Notably, diabetes mellitus (DM) now accounts for nearly 45% of new ESKD cases.3 Approximately 20% to 40% of patients with diabetes develop kidney disease.4 Patients who have received kidney transplants account for an expanding fraction of the CKD population. Although kidney transplant may cure ESKD, the transplanted kidney may eventually fail for a number of reasons, including recurrent damage from the original systemic disorder, acute or chronic rejection, and drug-related nephrotoxicity associated with the use of certain immunosuppressants (e.g., cyclosporine, tacrolimus). Kidney transplant recipients are a very complex subset of patients; however, many of the issues managed in CKD remain pertinent to this population. [11] We report one such case of chronic kidney failure in a 13 years old male who was diagnosed with CKD due to Aprot’s syndrome 6 years back. Patient developed malignant hypertension and pulmonary edema and on maintenance hemodialysis who was treated by Dr. Appa Rao with the protocol involving immunonutritive therapy.