Case Study of Melanie: Medical History, Renal Failure, and Hemodialysis

Running head: CASE STUDY OF MELANIE
Case Study of Melanie
Name of the Student
Name of the University
Author Note

CASE STUDY OF MELANIE
1
Response to Question 1.1
The case study depicts about the medical history of Melanie Johnson who is a 55 year
old woman and lives in rural region of Victoria. According to the human anatomy, the
kidney of the human body is a bean shaped organ that originates from the vertebrates. They
are located in the retroperitoneal space of the left and right side of the human body. Both the
kidneys are protected by the renal capsule that is fibrous connective tissues and apart from
that there are two different layers of the fat bodies that provides extra protection to the organs
and specifically to the outermost layers of the organ that is renal fascia (Natsis et al., 2014).
The internal part of the kidney is divided into three parts and they are renal pelvis, renal
medulla and renal cortex. The functional and structural unit is to referred to as nephron and
this unit is comprised small tubules and the tiny vessels receives fluids from the blood vessels
of the cortex region of the kidney (Dalton & Haguenau, 2013). The hormone erythropoietin is
produced from the renal cortex region. The structure named Bowman’s Capsule present in the
cortex is associated with the blood filtration function of the nephron. The renal arteries are
located in the renal pelvic region and it is branched into abdominal aorta that supplies blood
to the different regions of kidney. Apart from that, both the kidneys are attached to ureter
that carries urine to the urinary bladder (Natsis et al., 2014).
Response to Question 1.2
From the case study of Melanie Johnson, it can be stated that the patient is suffering
from renal failure and along with this she also experienced nausea, general pruritus and
enhanced tiredness.
The study of Liyanage et al. (2015), stated that chronic renal failure is the progressive
and permanent loss of the functions of the kidney and this condition leads to gradual
functional loss of the filtration capacity of the glomerulus. In this case scenario, the patient

CASE STUDY OF MELANIE
2
had high blood pressure (190/100) that is quite abnormal while considering the range of
normal blood pressure range (120/80) (AlGhatrif, & Lakatta, 2015). Kidney is engaged in the
function of filtering the waste products of the bloods and also the extra body fluids. The
condition of high blood pressure can cause narrowing of the blood vessels present in the
kidney region of the human body. The palpation condition of the patient poses the risk of
heart failure and thereby enhances the blood pressure of the main vein connected to the
kidney by showing abnormal cardiac rhythm (Liyanage et al., 2015). As a consequences of
this altered blood supply to the kidney, the glomerular filtration rate was also reduced in case
of Melanie. The study of Gebäck et al. (2015), reported that normal range of GFR for woman
should be within 90- 120Ml/min/1.73m2 but in case of Melanie the GFR was almost
10ml/min/1.73m2. The altered serum creatinine level of the patient is also associated with the
altered function of the kidney. According to the study of Anders, Davis and Thurau (2016), it
is stated that the altered kidney function is unable to eliminate the urea from the blood in a
proper manner and thus blood urine level is enhanced in this case study. The blood serum
urea level is 17mMol/l and due to this same mechanism serum potassium level is also higher
than the normal level in case of Melanie (Melanie-5.7mmol/l ; Normal range- 3.6 to 5.2
mmol/L).
In this context, there will be clinical manifestations such as heart failure, uremia and
hyperkalemia. The condition of uremia may be reported due to the high level of urea and
hyperkalemia is the result of enhanced blood potassium level. The condition of hypertension
may cause heart failure as well (Morrissey, 2014). In this condition, transplantation, renal
replacement therapy and consumption of vitamin D supplementation can be prescribed for the
treatment (Webster, 2017).
Response to Question 1.3