Study on Renal System and Chronic Renal Failure

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Running head: STUDY CASE
Student's Name:
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Institutional Affiliation:
Date
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The renal system consists of a pair of kidneys, together with two ureters, a
bladder, and also the urethra. The kidneys themselves are retroperitoneally organs that are
located along the rear wall of the abdominal cavity. Kidneys weigh approximately 120-170
grams. They are covered by a capsule of fibrosis tissue, and above them lie the adrenal glands.
Kidneys have two distinct regions of renal parenchyma consisting of the cortex and the medulla.
The cortex is made up of blood vessels that connect to the nephrons while the medulla is
organized in a pyramid shape that consists of bulks of nephrons. The ureters themselves are
considered to be narrow, muscular tubes that connect the kidneys to the bladder about 24-30 cm
long. The bladder is attached to pubic symphysis through the pub prostatic ligaments, and a
urethra about 4 cm extends from it through the pelvic floor to the perianal floor. The key roles of
the renal system include the excretion of metabolic waste such as urea and uric acid and
metabolism of drugs. Additionally, the kidney is involved in the regulation of electrolytes, fluids
and the ph. of blood and glucose levels compounding to the blood volume and osmolality.
Thirdly, the kidney has many endocrine functions which include the stimulating and conversion
of vitamin D into its active form which is calcitrol (Haley et al., 2018).
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Chronic renal failure is an irreversible loss of kidney function including the
maintenance of fluids and electrolyte balance which is marked by glomerular filtration rate <60
ml/min/1.73m2, for more than three months with or without kidney damage. It's classified in
stages: reduced renal reserve where nephron damage is estimated to be 40-70% there are no
symptoms since the nephrons are able to carry out their normal functions. Renal insufficiency is

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another stage where nephron damage is estimated to be 75-90% damaged markers include a rise
in creatinine and blood urea levels, and anemia develops Hemoglobin of 95 g/l results presented
by Melanie. End-stage renal disease is marked by less than 10% nephron functioning it's marked
by increased azotemia, cardiovascular manifestations palpitations, headaches and hypertension,
dermatologic symptoms like pruritus, gastrointestinal manifestations nausea, vomiting (Lim et
al., 2019).
Risk factors for Melanie include her age as she is 55 years. Based on the fact
that renal functions decreases as from the age of 30 years, this proves a great risk to her health
state. Additionally, her cardiovascular diseases are also evident in the client since she has had
palpitations for more than five years- which proves an evidence for more risks to health.
Compounding to this an exposure to toxins also proves a risk to he health since she has a history
of working as a farmer for most of her days and has ,therefore, been exposed to chemicals. She
also has a history of using ibuprofen an naproxen drugs that have a tendency to cause hypo
perfusion of the kidney and also lead to ischemia. Compounding to this her socio-economic
status is also linked to the disease prognosis since she was not able to afford medical expenses
when the disease was at its early stages of progression.
Anemia is one of the complications associated with chronic kidney failure; it
results due to decreased synthesis of erythropoietin a glycoprotein that is essential in the growth
and differentiation of red blood cells in the bone marrow. Other related factors include vitamin
B12 deficiency, gastrointestinal bleeding, and shortened survival span of red blood cells.
Cardiovascular diseases like hypertension develop due to fluid volume excess resulting from
sodium and water retention. Bone and mineral disorders including otitis fibrosis cystic,
osteomalacia, and A dynamic bone disorder results due to hypophosphatemia, low calcium level,

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and abnormal vitamin D absorption in the body — hyperkalemia due to reduced excretion rate of
metabolic waste products resulting to metabolic acidosis. Alteration in nutrient utilization results
due to decreased metabolisms of nutrients such as protein and carbohydrates, this leads to a
decrease in energy generation despite satisfactory intake. These conditions worsen in chronic
renal disease patients to uremic malnutrition caused by both inadequate intake and ineffective
utilization of nutrients.
The major goal of treatment is to maintain kidney function for as long as
possible modalities include drugs, diet, and dialysis to decrease uremic waste levels in the body.
Drugs include: antacid such as calcium carbonate and phosphorus are used to reverse
hypophosphatemia and hypocalcemia. Antihypertensive drugs are used to control intravascular
blood volume example diuretics, inotropic agents, others modalities to lower blood pressure
include sodium and water restriction. Ant seizure agents such phenytoin and diazepam are
administered to curb neurological abnormalities such as delirium, seizures, and headaches.
Recombinant human erythropoietin is administered to achieve a hematocrit level of above 38%
to decrease the symptoms of anemia in patients with chronic kidney disease.
Nutritional interventions include Adequate caloric intake, vitamin
supplementation, restriction of protein, fluid, and sodium intake.
1.3 Acute kidney disease is characterized by a sudden onset loss of kidney
function while chronic renal failure is slow and progressive .acute kidney disease lasts over a
period of hours to days while chronic renal failure diseases last for a period of more than three
months .acute kidney disease is reversible while chronic renal failure is irreversible. It is worth-
noting that acute kidney disease presents itself in four stages while chronic renal failure presents