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

### input:
Hi i am 65 years old i have a problem of ckd and high blood pressure as directed by Dr i am having these medicines (moxovas 0.3,tolo xr 50,sevcar400,dytor40,trinerve Lc,carnifer,cilacar10,rosuvit cv5,febuget40, now from 2,3 days my bloods pressure is getting low so what should i do at this time

### output:

Hi, Chronic Kidney Disease (CKD) is due to persistent underlying disease like diabetes, uncontrolled high blood pressure, untreated kidney stones, rarely it may develop as a consequence to AKA (Acute Kidney Injury). Treatment of CKD is to prevent or to slow the process of deterioration of kidney function. It requires-1) Diet with adequate vegetarian proteins.2) Control of Diabetes, blood pressure, cholesterol.3) Avoidance of nephrotoxic food and medicines like pain killers4) Water intake needs to restrict if there is tendency to retain water.5) Low Potassium intake (avoid intake of fruit and fruit juices, coconut water) in case there is potassium retention in body.6) Maintain calcium, phosphorus, uric acid levels under control.7) Avoid smoking, alcohol. 8) Screening for complication on heart. Usually CKD associated with high blood pressure that requires multiple medicines to control. Development of low BP in patients of CKD with Hypertension indicate-1) Further deterioration of kidney function which leads to accumulation of Chat Doctor. 2) Overdosing of medicines.3) Development of Autonomic neuropathy as a complication of CKD its self or its underlying cause like diabetes, hypertension.4) Development of other complications like heart. So it is advisable you to consult your doctor and get detailed clinical examination and investigations that may help in decision-making -Complete blood count, kidney function test, electrolytes, calcium, phosphorus, uric acid, urine examination including 24 hours protein level, ultrasound of kidneys. Modifiction of medicines is required. There might be impending Need for Hemodialysis which depends on on-1) Amount of Urine production daily.2) Serum electrolyte mainly Potassium.3) Serum Creatinine level.4) Arterial Blood Gas (ABG) analysis which denote degree of acid accumulation in blood.5) Signs of water retention like breathing difficulty, swelling over body, puffiness of face.