{"text":"NHS Confidential: Personal data abouta patlent \nNHS Lanarkshire ' University Hospital N H S \nwww.nhslanarkshire org uk ;\\V\/%ml\ufb01lands A \nRena! Medicine onkscourt Avenue \\fm :mm\ufb01 \n01698752428 \u2018 Airdrie . \nRenal ' ML6 OIS Lanarkshire \nDr R Maclnnes Date Dictated: 241112022 \nKilsyth Medical Partnership Dale Typed: 02\/12\/2022 , \nKilsyth Community Health Centre Rel: 3277096 \nAirdrie Road Le_tter Ref: RM\/ALL \nKitsvth * Clinic Date: 24\/1 12022 \niisyt CHi Barcode; \n*12098 23403 % \nConsultant: \nDear Dr MacInnes, \nPatient Name: . Patricia Hunt \nPatient date of birth: 12\/09\/1982 \nPutient Address: 22 Cuilmuir View, Croy, Glasgow, G65 9HH \nDiagnosis: \n28\/11\/2022 (CKD) Chronic kidney disease - stage G3b Al \n28\/11\/2022 Hypocitraturia \nPrimary Renal Diagnosis: Not yet cocled \nI saw Miss Hunt at Dr Nolan's peneral nephrology clinic today. She is a 40-year-old lady with presumed distal renal \ntubular acidosis type 1. Since her last review in clinic, at the end of October, her urine citrate result over 24 hours has \ncome back showing her urine citrate is less than 0.1 and the urine citrate creatinine ratio cannot be calculated because it is \nbetow the lower limit of detection, This confirms the suspected diagnosis. . \nOn examination today, her weight is down to 47.6kgs but she states that she has been eating normally other than having a \nfew days a few weeks ago when she did not eat.because she had a cold. She states she is drinking plenty of water, at least \n3 litres a day and her renal function is pretty stable since her last clinic attendance. Her urine dip once again is positive \nfor nitrites and leucocytes but she is a-symptomatic of UTL I have sent off a urine culture today. \nAs per Dr Nolan's previous comment in August 2022, the plan is now to move her from sodium bicarbonate onto \npotassiun citrate. I discussed this with Alison, our renal pharmacist, who advised that the newer preparations are not yet \nlicenced and so as agreed with Dr Skamperdoni we should start her on citric acid with potassium citrate which is 10mis 3 \ntimes a day to replace her sodium bicarbonate. I would appreciate if this could be changed in practice as these discussions \nwere had after the patient had ieft the clinic. She will receive an appointment for 2 months' time and she has been given a \nblood form including a glucose, as her random glucose was raised at 10.1, She has been given worsening advice \nregarding urinary tract infection and is aware to present if she develops worsening symptoms. \nAction for GP; Please change Sodium Bicarbonate (Stop) to Cilric Acid with potassium citeate 10 mls 3x a day, \ndiluted well with water as per the BNF, ) \nYours sincerely \nDr Rosa McMilian ' \nIMT1 \nAuthorised on 08\/12\/2022 17:31:38 by Rosa McMillan. \n\" Recent Results \nDale Time Test Result Uity \n\u2018 127102022 Systolic BP 1) nun Hy \n. 17\/10:2022 ' Diasiolic B 78 aan g \n17102022 Weight 16.9 ki \n231172022 10:00 Potassiumy 4.7 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