<s>[INST] Hi doctor This is ashwin rao from india. My mom is a kidney patient . Her creatininie level 4.8 and BUN is 72 and she has got chronic cough if she sleeps flat on her bed at night, effect is more after 48 hours after dialysis , we do dialysis on wednesday and saturday.she was operated for fistula care AV and doctor has recommeneded to use ecosprin 75 mg daiuly once in the afternoon.does ecospirin is creating such problem ? please assist . tablets taken apart from ecosprin, amlog 5mg -1-0-0, lanum C 1-0-1,domstal 1-0-1, panram 40mg 1-0-0. [/INST] This does not look to be drug induced. It seems more due to water accumulation in the lungs just before dialysis. You should restrict her oral fluids to the amount that her weight gain between sessions of dialysis is less than 2lt. Also cardiac evaluation by an echocardiography is indicated to check the pumping of her heart. Most importantly restrict the oral salt to less than 2grams per day. </s>