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

### input:
diabetic woman with tuberculosis in the past 21 years ago treated,continues tuberculine skin test  have positive, she has BUN 27 and creatinin 1324 ,WBC 12000 NA 136,she started with confusion why and computed tomography of the brain is normal in basal cisterns and ventricules

### output:

Hi Dear !! Thanks for your query to Chat Doctor. Read and reviewed your query and health concerns. My opinion-IN the given situation, You seem to be having-Diabetic Nephropathy with mild CKD(Chronic kidney Disease). Confusion lately observed is due to uncontrolled diabetes, as the brain CT is normal. Dos Suggested-You need to concentrate on correction of diet / exercises/ and low protein, low salt diet with medicines under care of Planetologist and Nephrologist, who would treat it according to the investigation and clinical assessment. Old TB revival need to be observed being diabetic. TB revival could be ruled out in view of confusion before planning any further care in your case.IRA blood test-for ruling out-active TB infection needs to be repeated to rule out activated TB lung infection. Other causes need to be ruled out after proper check up physically and after investigation from Physician/ Planetologist and Nephrologist- if need be. Rule out other causes, before concluding treatment on above lines. This briefing reply is on facts submitted, which need to be verified from your attending doctors, with whom you can check before starting further changes in the treatment of your dad. Hope this would help you to plan further of this complex illness of yours. If need be, update any health issue 24 x 7 by a direct question to ME, at following Chat Doctor link-http://doctor.Chat Doctor .com/Funnel?page=askDoctorDirectly&docId=70229 Dear, if satisfied, Dont forget to close this query with YOUR pleasing feedback comments to rate this reply and service, to boost the morale of incoming Emergency patients like YOU, at Chat Doctor services. If you want to update more details and ask more update queries, You are most Welcome herewith !! Good Day!! Wishing Good Healthy Life in time to come!!  Chat Doctor. N. Senior Surgical Specialist M.S. Genl-CVTS