Case Study on Hypertension leading to End stage renal diseases

Case Study on Hypertension
leading to End stage renal
diseases

Table of Contents
Introduction......................................................................................................................................3
Case .................................................................................................................................................3
Pathophysiology...............................................................................................................................4
Medical management ......................................................................................................................6
Pharmacological treatment...............................................................................................................6
Renal Replacement Therapy............................................................................................................7
Renal Transplantation......................................................................................................................8
Nursing management.......................................................................................................................8
Diet management.............................................................................................................................8
Fluid and electrolyte management...................................................................................................9
Health education and providing support..........................................................................................9
Recommendation...........................................................................................................................10
Conclusion.....................................................................................................................................10
References......................................................................................................................................12

Introduction
The disease related to kidney is observed that it has been increasing rapidly in past few
years which impacts negatively on morbidity and mortality rate at global level. As per views of
Babitt and Lin (2012), it has been analysed about the criteria that there is increment around 32 %
amongst a group of individuals because of health problem related to kidney since year 2005 by
the help of global Burden of Disease 2015.
ESRD stand for end stage renal disease which is known as last phase (stage 5) pof
chronic kidney disease that means that kidneys are functioning only 10 to 15 percent of their
normal capacity. Basically, the decreased rate of glomerular filtration, boosting up in amount of
albumin excreted urine or both conditions occurred then the situation is known as of chronic
kidney disease. According to opinion given by Helal and et. al. (2012), boosting up global
outputs in context of kidney disease defines that the health problem of chronic kidney is
responsible for damaging in pair of kidneys or it may create issue of decreasing glomerular
filtration consist low rate as compared to 60mL/min/1.73 m approximately for duration of time
including 3 months or more regardless of cause. However, there are several factors which can be
considered as key reasons which are responsible for causing chronic renal failure that involves
certain issues such as diabetes, kidneys disease, hypertension and an acute kidney failure
accordingly.
The present report will focus on the case scenario given here and medical problem of
stag renal disease of issue of hypertension with the help of conducting management and
pathophysiology of the diagnosed health problem along with considering to follow accurate
suggestions in context of future clinical practices for better outcomes.
Case
In selected case scenario, a patients named Mr. A having an age of around 70 years who
came to hospital for consulting regarding an issue of the generalised fatigue or weakness, edema
abdominal distension along with severe pain for approximately 2 days accordingly. However, the
given sick individual has past history of including hypertension and give opinion of having
treatment of the same at that time but due to low compliance, he state that he never had any other
disease previously. Moreover, it is observed that patients did not smoke as well as not have a

routine of working for earning. At the other hand, the selected ill person is currently living with
his daughter who take care of him because his wife has passed away some years back. In
addition to this, as per his statement, he does not consist any type of disease in his family history.
After conducting desired diagnosing activities as the patient was diagnosed that he has a problem
of chronic kidney failure along with symptom of fluid overload as well as hypertension.
Pathophysiology
Pathophysiology can be described as a process of to analyse disorder physiological
procedures associated with disease or injury. It is observed that nephrons in kidneys are consist
of a complicated web of blood vessels along with huge amount of flowing blood through the
same as they are responsible for supplying blood in whole body. However, it is analysed that
renal arteries become narrow, weaken or harden because of condition of uncontrolled high blood
pressure among the vessels. James, Hemmelgarn and Tonelli (2010), states that some of health
issues such as stroke, coronary artery disease, heart failure and systolic hypertension are
affirmatively related with arterial stiffness. As mentioned by Washington, Zimmerman and
Browne (2016), the health problem of high blood pressure is responsible for damaging the
arteries and the circulating fat ion blood get deposited in damaged arteries which is responsible
for losing elasticity of arteries and eventually become hardens. Ellam, Twohig and Khwaja
(2016), states that it is evaluated that nephrons are not provided with nutrients and oxygen at the
time of renal arteries become spoiled as well as kidneys lose ability of functioning of conducting
filtration of blood & fluid, hormones, acids and salt regulations in the whole body. It is analysed
that glomerular filtration rate of kidney get reduced due to decreased flow of blood which is
responsible for ending the activation of rennin angiotensin mechanism. As mentioned by Lorio
and et. al. (2013), there are number of major constituents of rennin angiotensin aldosterone
systems such as angiotensin II, rennin and aldosterone. As per views of Cheng and et. al. (2017),
these three components plays an important role in respect of rising arterial pressure in response
to reduced renal blood pressure respectively. As per mentioned by Chan and et. al. (2016), it has
been accomplished through reduced delivery of salt concentration to the distal convoluted tubule
and/or beta-agonism. Initially, the increase in Na-H exchange in order to boost up reabsorption
of sodium take place by action of Angiotensin II. It will responsible for improving the blood
osmolarity which has finished up facilitating shifting the fluid into extra cellular space as well as
blood is observed to be boosting up respectively. According to opinion given by Wongrakpanich