A fifty eight
years old male had pain in loins since three months. Additionally
he had edema of both feet since 3 months. Pain dull aching
< at night and Evening
History of presenting complaints
was apparently well 3 months back gradually develop pain in right
loin and then in left loin associated with constipation with hard
stool bleeding per rectum after passing stool. After 2-3 days
he developed swelling of both feet with heaviness and stiffness
of both lower limbs approached to a physician underwent investigations
diagnosed as chronic kidney disease with hypertension advised
dialysis so he approached to our hospital to avoid dialysis.
with accident while travelling in bull cart injury on back without
H/O Other Specific Illnesses, Operations.
relevant family history.
Thirst-Moderate, 4-5 glasses/day
Urine- D/N -3/1
Bowels-Regular and satisfactory
Sleep –Refreshing, snoring, dreams of daily events
Thermal State- Chilly patient+++
Habits – smoking from the age of 17 used smoke 2-3 packets
of cigarettes, stopped since 3 months.
built, well nourished with grey hair, edema of both feet clubbing
-+ Vital data- BP-140/90 mm of Hg with Rx on anti-hypertensives,
PR-72/min regular in rhythm, HR- 72/min , RR- 18/min, TEMP-A febrile.
–No organomegaly , pendulus abdomen. No tenderness.
USG dated 4th feb 2013 –abdomen –bilateral
renal parenchymal disease
Hb % - 8.o mg/dl
Serum.creatine -5.0 mg/dl
Urine - Albumin-++
3-4 pus cells/hp,1-2 epithelial cells
Bilateral Renal Parenchymal
Disease-Chronic Kidney Disease.
1. Pain in loins –dull aching <night.
2. Edema of both feet <night,>morning.
3. Disturbed sleep
4. H/O smoking
Advised low salt diet, low
protein diet. Monitoring of 24 hours urine output.
Remedy prescribed – Ars.alb 200
1. 21/2/13.- Ars.alb.200
2. 23/2/13- swelling of feet reduced slightly. Pain in loin was
reduced. Bp-140/80mm of hg .Rx – SL- 3 doses.
3. 24/2/13 -No specific improvement than yester
day –Bp-130/80 mm of hg Rx – SL- 3doses.
4. 25/2/13- swelling of feet reduced, pain
in loins was reduced. Bp- 140/80 mm of hg Rx-Ars.lab 200-1 dose.
Advised for s.creatine levels and CBP, ESR,CUE.
5. 26/2/13- feeling better, edema is reduced,
loin pain slightly present Bp- 140/80 mm of hg Rx- sl-3 doses.
Serum creatinine 3.7 mg/dl
Feeling better but not complete relief RX- Ars.alb 200 –
Patent was discharged advice for regular check up in OPD.
This was a case of one sided
disease with poor function of both kidney Ars.alb 200 advised
as partial similimum. Patient was improved but not completely.
In this case Dr. kent’s 7th observation was observed amelioration
of symptoms but no special relief. Because of gross pathological
changes patient was improved some extent but not completely. This
case was still on observation.