Dr.Divya chaitanya

 Internal assessment:  Antomocal Diagnosis: glomerulus of kidney Histological: ? Loss of effacement of foot process of podocytes of basement membrane ? Membranous glomerulopathy Etiological: diabetes and hypertension. Diabetic nephropathy    2.azotemia : Increased blood urea nitrogen with BUN to creat ratio 20:1 suggestive of renal or post renal azotemia. https://www.ncbi.nlm.nih.gov/books/NBK538145/   https://www.ncbi.nlm.nih.gov/books/NBK538145 Anemia:https://pubmed.ncbi.nlm.nih.gov/6876938/ https://spectrum.diabetesjournals.org/content/21/1/12 Hypoalbuminemia: Reduced protein intake and inflammation,due to reduced production of albumin by liver leading to decreased synthesis and increased catabolism and vascular permeability. https://pubmed.ncbi.nlm.nih.gov/9848794/ Acidosis: renal failure as there is decreased synthesis of bicarb resulting in high aniono gap metabolic acidosis. https://pubmed.ncbi.nlm.nih.gov/6876938/ 3.according to KDIGO guidelines,oral replacement therapy is init