MEDICINE CASE DISCUSSION This is an 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 centered online learning portfolio and your valuable inputs on comment box is welcome. CASE SCENARIO: A 63 year old male came for dialysis HISTORY OF PRESENT ILLNESS: Patient was apparently normal 3 months ago, then he had c/o dribbling of urine, swelling of arms and legs, facial puffiness, nausea, vomiting, constipation and abdominal discomfort for which he went to a hospital in khamman where investigations were done. 1/9/2021 RBS: 215 mg/dl Blood urea: 109 serum creatinine: 5.3 Uric acid: 8.9 albumin: 3.2 CUE: sugar ++ He was advised adm