69 Likitha Godavarthi

1. How does visceral fat lead to chronic kidney disease ? Increased visceral fat accumulation causes adipose tissue inflammation and adipokine dysregulation , which can lead to dyslipidemia, insulin resistance,   renin-angiotensin-aldosterone system (RAAS) overactivation  ,   sodium retention , extracellular fluid volume expansion. Increased visceral fat accumulation is also accompanied with perirenal and renal sinus fat accumulation, which causes high intrarenal pressure, which leads to compression of the vasa recta capillaries and thin loops of Henle, reduced blood flow in the renal medulla, increased sodium reabsorption in the loop of Henle, RAAS activation, and increased sodium reabsorption These pathological conditions interact in a complex manner, ultimately damaging the kidneys by causing glomerular hyperfiltration  and inflammation   both of which are characteristics of obesity-related kidney disease Reference -  https://www.frontiersin.org/articles/10.3389/fendo.2023.1097596/f

  This is online E log book to discuss our patient’s de-identified health data shared after taking his/her/guardian’s signed informed consent. Here we discuss our individual patient’s problems through series of inputs from available global online community of experts with an aim to solve those patients’ clinical problems with collective current best evidence-based inputs.  This e-log book also reflects my patient centred online learning and your valuable inputs on comment box is welcome. I’ve been given this case to solve in an attempt to understand the topic of “patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations, and come up with diagnosis and treatment plan. A 55 yr old male from suryapet  came with chief complaints of generalized body swelling since 15 days,shortness of breath since 15 days, decreased urine output since 10 days. History of presenting illness: Patient was appare