75 yrs old Male with CKD

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A 75yrs old male patient came with 

C/O B/L pedal edema since 15days

C/O SOB since 7days

Patient was apparently asymptomatic 15days back then he developed b/l Pedal Edema insidious in onset, pitting type, gradually progressive to B/L knees,SOB grade 2 to 3,associated with orthopnea

Past history 

K/C/O HTN since 7months on Tab.NICARDIA 10 mg PO/TID

N/K/C/O DM,TB,Epilepsy,BA

Personal history 

Diet-mixed

Appetite-decreased

Bowel and bladder movements-regular 

General examination 

Patient is conscious,coherent,cooperative 

Bilateral Pedal Edema present

Vitals 

Temp-afebrile

PR-98bpm

RR-15cpm

BP-150/90mmHg

Systemic examination 

Cvs-S1,S2 heard

RS-BAE present,NVBS present

CNS-NAD

P/A-soft,non tender ,bowel sounds present.

Provisional diagnosis

Chronic kidney disease 

Investigations

Rft

CUE

CBP

Treatment

1.Fluid restriction <1.4l/day

2.Salt restriction <2.4g/day

3.Tab.Lasix 40mg/BD

4.Tab.Nicardia 10mg PO/TID

5.Tab.Shelcal 500mg PO/OD

6.Tab.Nodosis 500mg PO/OD