93 femal patient admitted via ER suffer from lower limb oedema right hand swelling and she can't move them about 2 months ago ,alternation of conscious and by taking blood sample thay find Kidney function 19% , animea . there is chang in bowel habit difficulty in swallowing and some time shortness of breath . the last 6 month she gives about 6 blood unit Bp is normal no DM no hisory of MI is there any clear diagnosis or treatment plz