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

### input:
Hello father is a patient of Chronic Kidney Disease. He is undergoing Haemodialysis twice a week since Oct 2008, which started when he was admitted to hospital after Heart attack, which was followed by Angioplasty. This resulted in steady increase of creatinine and dialysis started then onwards.LAst week, his upper hand swelled enormously due to ( i think) blood oozing out and accululating inside his upper arm) just above the fistula) from fistula due to accidental wrong way of puncturing the needles of the pipes for haemodialysis (during one of the dialysis sessions).  Thereafter he was prescribed Bruffen 200 mg thrice daily after food for 5 days, with application of ice pack on the swelled hand( we can see clotted blood and his hand has become violet because of that). Is this okay for him and his heart and can taking Bruffen be detrimental/fatal to his health/heart. We are from India, Kolkata. He is 66 and with hypertension with medications and diabetes from long years. What can be effective now?? Or is continuing medication advisable.He is on medication like, Nikoran 10, concor 5, zytanix, rabicip, He is having breathelessness at any minimum exertion. Please help - A Biswas +91-0000

### output:

Hello, As such Broken is strictly to be avoided particularly in heart and kidney patients as it can cause per se increase in Creatinine and when you are on Ace inhibitor / ARB for Blood pressure and strengthen the heart, Broken has unfavorable interaction which may harm the kidney further.  So per se I would advise you to avoid Broken if possible.  As he is already on dialysis, so a short course is so.times sometimes of to take, however I would suggest that it is taken only if plain paracetamol 650 mg is not effective.  Regards 