|Subject: kidney patient
From: Amina <aminanbaba
Please do find attached a profile of a kidney patient who is my uncle. Please do contact me immediately with your opinion. i'm really counting on you. thanks a
28th November 2001
RE: BARRISTER MOHAMMED____________, MALE, 44 YEARS
The above named patient was referred to Dialysis Unit of National Hospital Abuja, on the 29th October 2001; with two years history of poorly controlled hypertension, with two weeks history of nausea, generalized body weakness, vomiting, anorexia and a decline in urinary output. He is not a known Diabetic.
Clinical examination revealed an ill looking young man, pale, not wasted with no pedal edema. His blood pressure was 140/80 at the time of admission. HS-1&2 only. He had minimal ascites. His lung fields were clear. He was drowsy with flapping tremors.
A clinical assessment of acute –on- chronic renal failure complicating poorly controlled Hypertension to rule out chronic glomerulonephritis was made.
He was admitted and blood investigation revealed a markedly elevated Creatinine level of 2487 umol/l, Urea 38.2mmol/l, K4.3mmol/l, HCO3 17mmol/l, Uric Acid 17.3mmol/l, Proteinuria +++, PCV 26%, Platelets 545x10/l. Urine m/c/s yielded no growth. HBs Ag and Retroviral screening were negative. He had evidence of poor corticomedullary differentiation in both kidneys, the Right kidney measuring 8.6x3.6cm.
He was commenced on Tabs Frusemide 80mg daily, Tabs Amlodipine 10mg daily, Tabs Fersolate 400mg b/d, Tabs Folic acid 5mg daily, S/c Erythropoietin 2000 IU twice weekly, Tabs Calcium lactate 500mg b/d and renal diet.
He had his first session of Haemodialysis on the 1st November 2001. He was discharged to the out patient clinic and dialysis unit on 6th November 2001 after three sessions of dialysis. He also had an Arteriovenous fistula created on 10th November to facilitate chronic dialysis.
He has been counseled about the option of renal transplantation as an alternative therapy for his present medical condition and he is willing to have the transplantation.
Kindly send him an estimate of the cost implication of the surgery including his living expenses with his donor and one other relative. He also needs an appointment for further review and possibly the renal transplantation.
Dr. M. H. Aminu
Medical Consultant, Apeiron Nigeria Ltd.