This is a 23 year old with no known medical illness presented with SOB, chest discomfort, throbbing headache. On examination GCS is full, BP176/102 on IV GTN, HR 100, afebrile, JVP is slightly raised. Lungs clear. CVS DRNM. Abdominal is soft. Beside ECHO showed EF 27% hypokinesia @ LV mid and septal ECG showed sinus tachy with LVH changes. CXR showed upper lobe diversion FBC- 9.1 / 12.3 / 299 ABG- no met acidosis Urine dipstick protein 2+ Was admitted as 1. APO secondary to HPT emergency 2. AKI secondary to uncontrolled HPT 3. Young HPT for ix In the ward he was started on Nifedipine 10mg TDS, IV GTN was continued, for hrly BP, IV burinex 2mg TDS. Usg kidney showed US KUB : 23.6.12 Findings: Both kidneys are small and echonegenic with very poor corticomedullary differenciation. BPL RK/LK : 7.5/8.8 No obvious stone or hydronephrosis No suprenal masses seen bilaterally Urinary bladder is underfilled with Foley s Balloon seen with No ascites Imp: Bilateral renal parenchymal disease ( Grade 3 based on USG appearance) Prazocin is started at 0.5mg BD. Nephro teaM IMP was AKI secondary to? missed GN with HPT emergency, TRO RAS. Decided not for renal biopsy as its not favourable. Thyroid function test are normal. Cortisol 293 Urine PCI is 0.22g/mmol creat And planned patient for RRT. On day 3 of admission, IV burinex is changed to lasik and GTN is off. His urine output is good, passing about 2300ml Discharge plan TCA nephro in 2/52 Advised for biweekly RP in nearest clinic Medication Metoprolol 25mg BD Felodipine 10mg BD Prazocin 2mg TDS Ca Co3 500mg BD Fe Fumarate 200mg OD Lasix 40mg OD Diagnosis Apo secondary hypertension emergency secondary to? missed gn ------------------------------------------------------------------------------------------------------- My last BP check at the nearest clinic showed a low pressure of 101/76 so please advice what dossage to reduce or stop, because I have an inflammatory on my throat, and always getting thirsty and is it and diet tips, what vitamins I should take more. Thanks