What is the cause for abdominal distension with fatigue and breathlessness?

Question

Hello doctor,

My father has a distended abdomen, fatigue, and occasional breathlessness on walking. I have attached the reports of my father. We are quite concerned seeing his low eGFR (estimated glomerular filtration rate), pre-diabetes values, cholesterol, etc. Please guide us on the best course of action. Kindly review his report and give us a suitable treatment plan.

Thanks.

Answer 1

Hello,

Welcome to icliniq.com.

I saw his reports (attachments removed to protect the patient’s identity). His liver function test, thyroid function test, and complete hemogram are all normal. There is a slight increase in his serum creatinine, and the rest of his kidney function test is within the normal range. The stages of kidney disease are based on GFR (glomerular filtration rate). GFR of 53.02 mL/min indicates stage three of CKD (chronic kidney disease). An increase in abdominal size could be due to edema.

At this stage, anemia and high blood pressure may occur. But fortunately, it is not the case with your father.

Kindly answer me the following;

1) What is his blood pressure?

2) Are there any urinary symptoms?

I would suggest you get a nephrologist appointment, as he would appropriately guide you further. If possible, meet the dietitian for a healthy diet to control sugar and lipid levels.

I hope you will find this information helpful.

Thanks.

Answer 2

Hello,

Welcome back to icliniq.com.

It is good that he is taking medications for his blood pressure. A decrease in urine output is a common symptom of CKD. Since when has this symptom been present?

I hope this helps.

Thank you.

Answer 3

Hi,

Welcome back to icliniq.com.

How is your father? I hope he is in good health and the medicine prescribed by the nephrologist is working for him as well.

I read the reports (attachments removed to protect the patient's identity) that you have attached.

Coming to your query:

• In the chest X-ray, there are increased bronchovascular markings. It could represent acute or chronic infection of the lung or the heart. Since the Echo of the heart is normal, it is unlikely to be due to the heart.

Does he have any history of smoking or chronic cough?

If there are any lung symptoms, this finding has to be correlated with the clinical picture.

• USG scrotum shows a cyst 5mm in the left testis, a grade 1 varicocele on the right side, and a grade 2 varicocele on the left side.

If the patient is asymptomatic, no intervention would be required. However, I would recommend getting a surgical opinion for the same.

• QTc means corrected QT interval. Generally, for men, it should be <0.45s. You have mentioned 0.488s, which is long compared with the normal upper limit value. There are various causes, such as electrolyte abnormality, certain medications, etc.

Among all your queries, you should visit an internal medicine doctor to interpret the QTc value and know its likely cause.

I hope you find this helpful.

Take care.

Thanks.