instruction: hello doctor I have swelling on my feet and tongue as well kit report was normal only my creatinine was 6 it is a chronic problem I have already used lasilactone 50 my and torsemide 10 my but no relief I use insulin mixtard 40 units twice and galvus met 50 850 be for my diabetes type maybe galvus causing swelling so I stopped it recently and want to switch over to janumet
output: hello according to your statement you are suffering from chronic kidney disease now you have swelling on feet ankles and tongues you have do diabetes mellitus for 20 years do you suffer from an allergy or are you allergic to some foods medications irritant etc hypersensitivity reaction can be a cause for your present swelling again you are a patient of chronic kidney disease so you can suffer from anemia either caused by chronic disease or vitamin b12 deficiency due to taking metformin for do if you have anemia you can suffer from the present swelling too again you are using drug like solitral for bah thelma for hen hypertension can cause swelling as their side effects and hypersensitivity reaction in case of heart failure liver diseases obstructive uropathy hormonal problem etc can cause swelling too so you should undergo some investigations like abc complete blood count he hemoglobin ear erythrocyte sedimentation rate to detect anemia status at present us ultrasound to detect obstructive uropathy or any other abnormalities skin prick test last test to detect hypersensitivity or allergens thyearoid hormone to ash to detect hormonal deficiency car chest ray to detect any abnormality in the chest egg electrocardiogram for cardiac status liver function test serum electrolytes etc at first we should find out the causes that are responsible for the swelling and then treat them accordingly so you should continue your current medications and inform me after getting the investigation results in your hand then I will try to treat you further