39yrs old man with body pain since 1yrs

39yrs old man with renal failure since 1yr..
Occupation__ painter (plastic paint)
Pain in abdomen since 2month....after eating burning neck to chest.....n abdomen...
(Evening 4pm.)__pain start..n relief in morning...
Pain in knee joint...n hand
Headache.....pinching sensation in head during driving...
Bacheche since 2month...
Difficulty breathing during walking....
Past/history ____
Before 1yr swelling  of face, hand and neck.....BP high....
Pain during walking...Difficulty during walking. ..
patient suffer from..Severe cough since 8_15days....... relief after treatment....
After 3month... patient complaining fever. ....weakness since 3_5 days...
Personal /history ___
11yr ago...drink n smoking...
Investigation___
Creatinine _8.9
Urea__ 217
Hb__ 8.4gm%