5 years ago (2001) noticed striae (stretch marks) on lower abdomen when patient got up one morning, visited a doctor and sent home with the advice of patient has loss weight in which patient claimed he was the same and the marks appear just over night.
 
3 years ago experienced blurring of vision while he was working. Visited the clinic in the working place and the doctor incharged found out he had a very high BP 180/220mmHg therefore he was sent to Melaka general hospital,Melaka, Malaysia. Admitted in hospital for 12 days, investigations done but BP did not drop even after medications. Patient insisted to be discharged and when he came back for the review, he was told he has polycystic kidney disease but do not require any dialysis yet. 2-3 weeks after admission, developed pedal oedema, consulted another doctor and this time his creatinine level was more than 600 (when hospitalised creatinine level was less than 200) and the doctor asked him to have AVF(left wrist).
 
Started dialysis 1 year and 2 months
 
Coping with the disease well. He was not feeling 'ill' until he started dialysis as now patient is not as active as before. Need lotsa effort to climb staircases.
 
Since dialysis, water intake allowed is only 500mL, reduced salt intake and does not take canned food anymore.
 
The disease is a burden to the patient but he can still work but a lot of time spent for dialysis, dialysis expanses are sponsored by government.
 
Wife is supportive and helping patient to cope with the disease.
 
Patient has 5 siblings. Elder sister is also diagnosed to have polycystic kidney disease.
 
Patient has 2 sons, 4 and 5 years old. He stays in a flat. Household income is RM3000/month.
 
Limb with AVF can carry only maximum weight of 5kg.
 
Latest Check-up
 
 
Renal Profile
Creatinine 972umol/L (62-115)
Urea 23mmol/L (3.2-7.3)
Uric acid 550umol/L (209-431)
Calcium 2.6mmol/L (2.1-2.5)
Phosphorus 2.7mmol/l (0.7-1.5)
 
Haematology
MCV 80fl (82-98)
MCH 26pg (27-33)
Polymorphs 77% (50-70)
Eosinophils 0% (1-4)
 
RFT
Urea 9.7mmol/L (3.2-7.3)
Creatinine 522umol/L (62-115)
 
LFT
Total protein 84g/L (64-83)
Globulin 39g/L (21-36)
 
Lipid Studies
Total cholesterol 5.3mmol/L (<5.2)
Triglycerides 8.2mmol/L (<1.7)
HDL-cholesterol 1.0mmol/L (>1.0)
Total cholesterol/HDL-cholesterol 5.5 (risk indicated if >4.5)
 
Others
Blood glucose 8.7mmol/L (fasting <6.1 random <7.
 
Electrolytes
Potassium 3.1mmol/L (3.5-5.1)
 
BP-128/82mmHg
 
Treatment
 
T. Norvas C 10mg
T. metaprolol 50mg OD
T. Lasic 40mg 11/11 BD
L. aspirin 300mg ¼ OD
CaCO3 11/11 Tbs
Vit. B complex 1/1 daily
Folate 1/1 daily
Racoitcol 0.5mg daily

Karen Soh 8th semester