Case Study: Renal Physiology Learning Outcomes: Apply physiological and biochemi
ID: 305961 • Letter: C
Question
Case Study: Renal Physiology
Learning Outcomes:
Apply physiological and biochemical knowledge to analyze case studies on pathological states.
Communicate biological information effectively in written work.
Apply physiology to relevant societal impacts.
Directions: Please read the provided case study and then answer the following questions. Your answers should be complete and detailed, including all relevant physiological details including hormones and renal control mechanisms. Each answer should be at least one paragraph.
A 24-year-old man visits his primary care physician after suddenly noticing that his urine was reddish-brown in appearance, and volume of urine was minimal. His medical history indicates he has been feeling tired and weak for several months. He states he hasn’t been sleeping well, and he appears puffy in the face. Patient is 5 feet, 9 inches, weight of 248 lb, and blood pressure of 160/100 mmHg.
Laboratory testing:
Hematology:
Serum sodium
125 mEq/L
Serum potassium
6 mEq/L
Serum creatinine
2.6 mg/dL
BUN
24.0 mg/dL
pH (arterial)
7.32
Hematocrit
25%
Urinalysis:
Appearance
Red to brown
Specific gravity
1.025
Blood
Positive
Glucose
Negative
Protein
Mild
Renal Function Tests:
GFR (glomerular filtration rate)
40 mL/min
RBF (renal blood flow)
280 mL/min
What are this individual’s most striking clinical and laboratory findings?
This individual would be mostly likely diagnosed with what disorder?
Name several potential causes of this disorder. Which is likely associated with this patient’s condition, why?
What is the cause of the hyponatremia and hyperkalemia in this patient?
Why is there blood in the urine?
What do the renal function tests tell you about the patient compared to a normal individual?
What caused the puffiness?
What medications would be appropriate to use to treat the increased blood pressure and how do they result in restoration of the normal blood pressure? (At least 3 different medications should be discussed)
Serum sodium
125 mEq/L
Serum potassium
6 mEq/L
Serum creatinine
2.6 mg/dL
BUN
24.0 mg/dL
pH (arterial)
7.32
Hematocrit
25%
Explanation / Answer
What are this individual’s most striking clinical and laboratory findings?
Radiolabeled strategies for estimating GFR are precise however not down to earth and can be utilized just on an exceptionally restricted scale while the customary techniques require planned pee accumulation with its downside of incorrectness, bulkiness and bother for the patients. Be that as it may, the improvement of equation based count of evaluated GFR (eGFR) has offered an exceptionally viable and simple approach for changing over serum creatinine esteem into GFR result contemplating.
Evaluation of renal capacity speaks to the commonest center research center testing that is performed around the world. The expanding commonness of numerous unending infections especially diabetes mellitus, hypertension, cardiovascular and renal ailments together with the expanding medicinal care and its effect on enhancing future have all fixated on the significance of organs capacities appraisal including in particular renal capacity. Perpetual kidney ailment (CKD) is likewise a huge hazard factor for vascular malady and early cardiovascular mortality and additionally movement of kidney sickness.
This individual would be mostly likely diagnosed with what disorder?
The approach of screening for any subordinate kidney harm has been encouraged and turned out to be routinely accessible with the coming of figuring the assessed in view of formulae that think about some of patient's qualities. By this approach, the consequence of serum creatinine is changed over. The creatinine-based ascertained eGFR has enhanced the legitimacy of serum creatinine which is viewed as alone a coldhearted list of glomerular capacity whereby in any event roughly half of glomerular capacity must be lost before creatinine is brought up in the blood.
Name several potential causes of this disorder. Which is likely associated with this patient’s condition, why?
Regardless of the continuous diagnostic change in the procedures of creatinine estimation, anyway still it is experiencing restricted affectability and specificity, expository obstructions and institutionalization problems.9 Serum creatinine is a poor screening test for CKD in elderly patients particularly ladies and may neglect to recognize half of patients with CKD organize 3.
What is the cause of the hyponatremia and hyperkalemia in this patient?
The serum sodium associated well with the serum osmolality especially when amendments were made for the osmotic commitments of glucose and no protein nitrogen. Of note, similar agents likewise perceived that the Na21-K1/add up to body water proportion related intimately with "rectified" serum sodium and clarified the significance for bookkeeping of potassium repletion amid the management of hyponatremia. Noted to be firmly managed by both the arrival of vasopressin and the kidneys' reaction. This interchange amid the 2 is basic for liquid homeo stability, a basic factor in the support of cell volume.
Why is there blood in the urine?
Net hematuria yields pink, red pee in view of the closeness of red platelets. It takes little blood to make red pee, and the depleting when in doubt isn't intense. Passing blood bunches in your pee, be that as it may, can be troublesome. These can happen when microorganisms arrive your kidneys from diffusion outline or transfer from ureters to kidney. Petite urinary depleting is a route of sign of glomerulonephritis, a bothering of the kidneys' filtering system. Glomerulonephritis may be a bit of a foundational disease, for instance, diabetes, or it can happen exclusively. Viral or strep pollutions, vein afflictions (vasculitis), and safe issues, for instance, IgA nephropathy, which impacts the little vessels that direct blood in the kidneys (glomeruli), can trigger glomerulonephritis.
What do the renal function tests tell you about the patient compared to a normal individual?
It's uncommon for strenuous exercise to prompt gross hematuria, and the reason is obscure. It may be associated with damage to the bladder, drying out or the breakdown of red platelets that occurs with upheld oxygen devouring action.
What caused the puffiness?
The irritation influences the measurement of the glomerulus. This is the channels blood to show besides evacuate squander. Thus, blood and protein show up in the pee, and abundance liquid develops in the body. Swelling of the body happens when the blood loses a protein called egg whites.
What medications would be appropriate to use to treat the increased blood pressure and how do they result in restoration of the normal blood pressure?
Solutions like lisinopril 40 mg every day to valsartan 320 mg day by day or treatment joined with continuously a low sodium (target 50 mmol/d) or a consistent sodium (target 200 mmol/d) count calories in a hybrid plan for four 6-week time spans.