### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Date 07/07/2011 Patient Id 0000 Emp. No. Report Date 07/07/2011 17:16 Name Mst. MALAY NEGI Age 8 Yrs Sex Ref. By Dr. C G H S Company CGHS CASH Test Name Value Unit Biological Ref Interval HAEMATOLOGY HAEMOGLOBIN (Hb) 11.8 g/dL 11.0 15.5 TOTAL LEUCOCYTE COUNT 6800 /cumm 5000 13000 DIFFERENTIAL LEUCOCYTE COUNT NEUTROPHIL 62 * % 40 60 LYMPHOCYTE 37 % 25 45 EOSINOPHIL 01 % 01 06 PERIPHERAL BLOOD PICTURE RED blood cells exhibit mild anisopoikilocytosis with occasional leptocytes & microcytes in picture. Hypochromasia observed with occasional pencil shaped cells. No codocytes or basophilic stippling seen. WHITE blood cells show no significant abnormality PLATELETS are adequate NO immature cells or hemoparasite seen. COMMENTS : MICROCYTIC HYPOCHROMIC ANEMIA . BIOCHEMISTRY SERUM UREA 105 * mg/dl 0 50 Tech:Urease/Cobas311 SERUM CREATININE 3.4 * mg/dl Tech: Jaffe/Cobas311 SERUM SODIUM 130 * mmol/L Tech:DISE/Vitros SERUM POTASSIUM 3.8 mmol/L Tech:DISE/Vitros SERUM CALCIUM 9.6 mg/dl Tech:OCPC/Cobas311 SERUM INORGANIC PHOSPHORUS 5.5 * mg/dl Tech:Molydate/Cobas311 SERUM ALBUMIN 3.5 * gm/dl Tech:BCG/Cobas 311  Sample Booking Time 13:10:29 TEST REPORT 07/07/2011 17:16 Name Mst. MALAY NEGI Age 8 Yrs Sex  CLINICAL PATHOLOGY URINALYSIS URE PHYSICAL EXAMINATION COLOUR WATERY CLEAR VOLUME 35 mL URE CHEMICAL EXAMINATION SPECIFIC GRAVITY 1010 PH 6.0 NITRITE NEGATIVE PROTEIN ++ GLUCOSE NEGATIVE KETONE NEGATIVE UROBILINOGEN NEGATIVE BILIRUBIN NEGATIVE URE MICROSCOPY EXAMINATION PUS CELLS NIL /HPF EPITHELIAL CELLS NIL /HPF RBCs NIL /HPF CASTS NIL CRYSTALS NIL OTHERS NIL My child is suffering from Hydronephrosis since last year and his left kidney functioning 72% and right kidney 22 % by DMSA scan on August 2010 report.

### output:

Hello, I have seen your child reports. The CBC is almost normal. Kidney function test suggestive of deranged kidney function and urine report suggestive of protein loss. As you already told about DMS scan function that was low. These all report suggest kidney disease. In this age, you have to investigate for etiology. Do ANA, Bag, CV, HIV. After then C3 level. Then go for kidney biopsy. Once cause is found then treat according to that. Meanwhile you have to watch for Urine output, Oral intake, swelling of body, serum potassium level and increasing pattern of urea and creatinine. If anything go wrong and patient became breathless or swelled then go for dialysis. Thank you