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Case of the Month

  October 2016

A 49 -year-old man,  who is under the care of the nephrology clinic as he has CKD due to autosomal dominant polycystic kidney disease admitted to the nephrology ward being unwell. He has a 3 day history of left loin pain, mild nausea, and fever. On physical examination, the patient looks ill. Temperature is 39 °C , blood pressure is 130/85 mm Hg, pulse rate is 110 bpm, and respiratory rate is 22/min. Chest is clear and heart sounds are normal. Abdomen is soft but with left costovertebral angle tenderness and bowel sounds are audible.

Laboratory results :

HB                          135 g/l

WCC                       15,000 X109 /l

S. creatinine             2.1 mg/dl (186 mmol/l)

Urine Dipstick           Negative

Negative urine culture.

Ultrasound KUB : the left kidney is 16.7 cm, and the right kidney is 16.9 cm; multiple bilateral intraparenchymal cysts are noted consistent with polycystic disease.


What is the most likely diagnosis?

Read: 1063 times Answered: 174 times Top score: 100%

Current Discussions

    • Dina Nabeel's Avatar
    • E cvp is low although it is a rough indicator of hypovolemia..but it is used to guide fluid replacement in early post op period..
    • 1 day 12 hours ago
    • delanaye's Avatar
    • OLA Tweet: Salt Restriction in...
    • I agree with Arif...but basically I think that our role as a doctor is to recommend the best practice for the patient. Try to help him. I believe that every CKD patient stage 4 should benefit from of...
    • 1 day 13 hours ago
    • sawsan mohammed babiker's Avatar
    • E: This patient needs more fluids replacement . Polyuria in the period immediately following the renal transplantation is a transient phenomenon, and it usually represents the first sign of...
    • 1 day 15 hours ago

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