Chronic kidney disease associated with acute kidney injury

 73 yr  male came to the op with complains of

1 burning micturition  :: 15 days 
2 fever  :: 15 days 
3  urge  incontinence ::5 days.
4 Pt complaints of  burning  micturation after urination not associated c loin pain.
5 Fever high grade intermittent  relieved c medication , c :: 15 days associated c chills and rigors .
6 Urinary urgency c:: 15 days :: not able to hold urine & wetting of clothes ,foleys catherization was done 

History of present illness
pt was apparently  alright  8 year back had h/o poor stream of urine burning mocturation ,feber undewent ransurethral resection of prostate(6 years in nims  back )
Was symptomatic free for 2 yrs  again developed  similar c/o underwent TURP 4 yr back in kims Nkp. 

Past illness: 
Hypertension  ::10 yrs.On   AMLODIPINE  5 mg  , ATENOLOL 50mg .
Diabetics mellitus type 2  inj . HM 15 IU 00-8am.

H/O Transurethral resection of prostate 4 YRS BACK was admitted in NIMS,symptom free upto 1 yr ,TURP -2 yr back.

PERSONAL H/O 
Appetite nprmal ,
Mixed diet, 
Band b regular
Micturation : Urinary urgency c:: 15 days :: not able to hold urine & wetting of clothes ,foleys catherization was done for it.
No known allergies
No Addictions. 

Family History 
No known case of diabetes melitus type II, hypertension, CVD or tuberculosis

Physical  exam :
Pt was concious, coherent, cooperative 
Moderately built,moderately nourished
No signs of pallor ,icterus ,cyanosis, lymphadenopathy, clubbing of fingers/toes.
Temp 98.6F
Pr 62 bp.
RR 22CPM 
BP 120/50mm hg
sPO2 96%on RA 
GRBS 197 mg%

Provisional Diagnosis: 

Posy renal AkI on CKD.
20 to BPH C BL Moderate  hydronephrosis,
s/p TIRP 2yrs back ---kims.
C urosepsis 4 yrs back Kims 
Kco DM2 & HTN. 

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