ADVANCED PATHOPHYSIOLOG DISCUSSION 2022

Running head: ADVANCED PATHOPHYSIOLOGY
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ADVANCED PATHOPHYSIOLOGY
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Institutional Affiliation

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Part one
1.1 Briefly describe the renal anatomy and physiology
The central medulla and the peripheral rim form the two basic principal divisions of the
kidney structure (Hall, 2015). Twenty-five percent of the cardiac output is received by the
two kidneys. Overlying muscle, ribs and the renal fat pad protects the kidney in the
retroperitoneal space. Lymph vessels, blood vessels, nerves, and ureters leave and enter at the
renal helium. Contents of the renal vein are directly drained into the inferior vena cava and
renal arteries directly arise from the aorta. Actions of about 1.3 million nephrons per kidney
derive the function of the kidney. These are termed as the functional units. Bowman's capsule
captures blood that has been filtered by a capillary bed, the glomerulus. The flow of blood
through the glomerulus enclosing the loop of Henle and proximal and distal convoluted
tubules forms a portal system. This second capillary bed covers most solutes and water. The
filtrate is further moved on to the renal pelvis and lastly to the ureters after it has undergone
processing and consequently brought together by the action of collecting ducts that finally
drain into the minor calyces (Moini, 2015). Constant favorable within the kidney ids
maintained through reabsorption, secretion, and filtration to ensure the survival of organisms.
1.2 Discuss the pathophysiology of chronic renal failure in Melanie, including her
risk factor(s), possible complications and treatment options
Pathophysiology of Melanie’s chronic renal failure
Destruction of Melanie’s glomeruli due to abnormal blood pressure consequently
increased protein filtration, leading to a high concentration of proteins in the urine ( Malek &

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Nematbakhsh 2015). This is referred to as proteinuria or microalbuminuria. Proteinuria is the
presence of albumin in the urine. This is often the first sign of chronic renal failure with a
glomerular filtration rate of <15 ml/min/1.73m
Melanie has proved to have some signs and symptoms of chronic renal failure. She
complains of nausea and increased weakness. Her blood pressure is also high despite not
being diagnosed with hypertension
Chronic renal failure risk factors
Family history- someone born in a family with previous kidney disease is more vulnerable
to infection. For instance, a study conducted in the United States in 2003 reveals participants
were requested to participate in a questionnaire-based about chronic kidney failure based on
their family history. Results of the study revealed that close to 30% of people suffering from
kidney failure had close relatives with end-stage renal disease (Zadrazil & Horak 2015).
Age- functions of the renal declines with age both in males and females. National Kidney
Foundation Kidney Disease Outcomes Quality Initiative reveals that over one- half of the
individuals screened among the elderly were suffering from renal kidney failure. Its
prevalence, therefore, increases with age.
Obesity is one of the leading risk factors of end-stage renal disease. Injury of the kidney
can be accelerated by glomerular hyperfiltration and hypertrophy through the decrease of
podocyte density and increase of capillary wall tension of the glomeruli.
Excessive smoking increases risks of ESRD through oxidative stress, glomerulosclerosis,
proinflammatory state, tubular atrophy, endothelial dysfunction, and prothrombotic shift.
Level of serum creatinine is increased by smoking.

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High blood pressure or hypertension is also another chronic risk for renal kidney failure.
Loss of kidney function and glomerulosclerosis come about as a result of systematic
hypertension transmission to intraglomerular capillary pressure. Hypertensive subjects have,
therefore, reported impaired renal function.
Possible complications
Kidney disease can cause crystalline arthritis (Cappell 2017). Crystalline arthritis may also
alter the normal functioning of the kidney, this is because filtration of uric acid occurs in the
kidney making the two diseases to relate to each other.
Red blood cells in the body are made with the help of the kidney. In a situation where the
kidney is malfunctioning, the body is likely to have few blood cells. This causes anaemia.
Hyperkalemia or high potassium is another likely complication. Excess potassium is
filtered from the blood with the help of the kidney. Kidney failure means a high accumulation
of potassium leading to hyperkalemia.
The kidney is responsible for excreting excess fluids from the blood. Enough fluid cannot
be taken out when the kidney is not functioning as it should. This results in the build-up of
excess fluid in the body.
Treatment options
For Melanie to recover from her illness she ought to change her lifestyle. She should take
a balanced and healthy diet, reduce her salt intake, stop smoking if she was a smoker, work
on reducing her weight in case of obesity and engage in regular exercise.