Polycystic Kidney Disease Case Study

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Medical History: A 72--year-old African American male with a history of CKD stage 5 in the setting of longstanding hypertension, possible polycystic kidney disease, BPH, obesity, who presents for evaluation for candidacy for a kidney transplant. The patient has been evaluated recently at Shands Hospital for kidney transplant, but his evaluation was not completed due to obesity and possible cardiac problems.

Renal History:
The patient has longstanding history of chronic kidney disease in the setting of longstanding uncontrolled hypertension. He has never had a kidney biopsy done. He had a renal ultrasound done in June 2013 that showed multiple simple cysts bilaterally of benign appearance with possible diagnosis of polycystic kidney disease. The patient was never diagnosed with autosomal dominant polycystic kidney disease in the past. No history of polycystic kidney disease in the family. His GFR was maintained around 22 for a couple of years, but recently, last year, he had a cardiac cath done in the setting of chest pain with deterioration of his
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He has obstructive sleep apnea and he is on a CPAP machine.

Gastroenterology:
No GERD. He has history of peptic ulcer disease with EGD done in December 2012 that showed erosive gastritis with biopsy negative for H Pylori. The biopsy was positive for chronic gastritis.

His last colonoscopy was in April 2012 that showed colitis that was not specific with negative biopsy. A followup was recommended in seven years.

Endocrinology:
The patient has no history of diabetes mellitus. His HBA1C is less than 6 per recent blood work. He had reportedly fasting glucose above 99 but less than 126. No glucose tolerance test was performed for the patient, but he had been informed by his primary care physician that he is borderline for diabetes. He has a history of hypothyroidism, as well.

Urology:
No history of UTI. He has a history of

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