30 year old man came with halitosis × 2 months with heaviness in chest. Nose, throat and oral cavity - normal. I personally couldn't pick the smell as I had a bad cold, but when my OPD nurse entered the room she gave a very bad face reaction and opened the windows which made me ask about the nature of the smell to the patient, revealed to be pungent, resembling urine. His creatine was 5.6 mg/dl and urea 243 mg/dl, BP 260/140 mm/hg and ECG showed features of LV failure. Diagnosed as CKD.
22 yr old girl referred from Gastro with abdominal pain, fever x 2 days after ruling out GI causes, she was detected to have worsening creat from 1.1 to 1.9 and urine out to 250 ml / day hematuria and 2 + proteinuria . With no known previous histories except for a URI 2wk back. She was evaluated on lines of acute nephritic syndrome ? PSGN ? SLE ? RPGN . RENAL BIPOSY by nephrologist was done started on IV methylprednisolone for 3 days followed by omnacortil and mycophenolate. Her ANA IF was 2+ and Anti ribosomal p Ab + However RENAL BIOPSY revealed post infections GN . She recovered in 1 wk.