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A 52 year old female patient came with chief complaints of pedal edema since 1 month and nausea and vomiting since 10 days. HISTORY OF PAST ILLNESS patient was apparently asymptomatic six months back and then on routine checkup she was found to have kidney problem . -from one month she developed pedal edema and gradually progressing which is of bilateral pitting type extending upto knees. -vomiting from 10 days associated with nausea and decreased appetite HISTORY OF PAST ILLNESS no history of SOB k/c/o type 2 Diabetes mellitus since 10 years. TREATMENT HISTORY have taken treatment for diabetes from 10 years PERSONAL HISTORY • She is unmarried. • She has decreased appetite. • Has regular bowels • Has normal micturition. • No known allergies and addictions FAMILY HISTORY -not significant. ON EXAMINATION : -Patient is conscious, coherent, cooperative. - pallor , Icterus,clubbing, cyanosis lymphadenopathy are absent. -malnutrition, edema present. Vitals : • BP - 140/80 mmHg •