A 35-year-old man complained of reduced vision in both eyes, that had started 2 months ago before presenting. He has no relevant medical history apart from intermittent headaches. Ophthalmologist’s Examination Best corrected visual acuity in both eyes: 20/80 Fundus examination revealed bilateral disc edema (Panel A, arrow), and macular edema with lipid exudates. Splinter hemorrhages, and cotton-wool spots. Blood pressure recorded was 190/100 mmHg.
He was referred to an internist. Internist’s examination Ultrasonography revealed shrunken kidneys (Right kidney: 77mm*36mm in the greatest dimension. Left kidney: 79mm*32mm) Loss of corticomedullary differentiation was noted. Chronic renal failure was ascertrained due to Serum creatinine: 9 mg /dL Blood urea nitrogen: 50 mg/dL Estimated glomerular filtration rate: 43 ml per minute per 1.73 m 2 of body-surface area. Treatment The patient was…
