Chronic Kidney Disease: Case Study and Discussion

Glomerulosclerosis develops, proteinuria markedly increases, and
systemic hypertension worsens.
Irreversible tissue damage reduced Glomerular
filtration rate
Suffering from type 2
diabetes mellitus
Hypertension , Hyerkalemia , Metabolic
acidosis
The ability to concentrate urine declines early
Puffiness around the eyes
Chronic Kidney disease : Glomerular disease,
Ischemic nephropathy, Obstruction in tubules and
kidneys,Vasculitis,Autoimmune diseases,
Infections and nephrotoxic drugs
Breath shortness
Treatment
Disease progression is more gradual and nephron adaptation
is possible.
Adapted nephrons enhance the ability of the kidney to
postpone uremia, but ultimately the adaptation process leads
to the demise of these nephrons.
When renal failure is advanced (GFR ≤ 15
mL/min/1.73 m2), the ability to effectively dilute
or concentrate urine is lost
Supply of
supplements for
cardiovascular
issues
Loss of
appetite
Glomerulosclerosis develops in these glomeruli,
and they eventually become non-functional.
Case study of patient –
History and Physical
examination
Ke
y
Arrythmias
Regardless of the primary cause of nephron loss, some
usually survive or are less severely damaged
Decreased renal function interferes with the
kidneys’ ability to maintain fluid and electrolyte
homeostasis
Swollen legs
Pathophysiol
ogy
Risk Factors
Aetiology
Signs and
symptoms
Diagnostic
tests
Fatigue
CT and MRI
scanning
Very
thin
Fatigue
increased Glomerular Pressure
Nephrons then adapt and enlarge, and clearance per nephron
markedly increases.
Physical
examination
Adapted nephrons have not only an enhanced GFR but
also enhanced tubular functions in terms of, for example,
potassium and proton secretion
Hypertrophy of neurons
Urine test
Itchy skin
Metabolic acidosis
treated using alkali
supplements
Decrease in ability to excrete excess phosphate,
acid, and potassium
Supply of
calcium
supplements
Chronic hypoxia leading to tubulointestinal injury
Edema-swelling
Sleeing
problems
Dry, itchy
urinary volume does not respond readily to
variations in water intake.
Imaging and Biopsy test
Treat anaemic condition using Erythropoietin,
Angiotensin converting enzyme inhibitors and
blockers for delaying chronic kidney disease
Serum albumin
test
Blood test
S5080326
Chronic Kidney disease

Chronic Kidney disease-Case study &Discussion
Based on case study of Steve McManus it shows he is diagnosed with chronic kidney disease due to diffuse nephron loss. His medical history indicates
he is suffering from type 2 diabetes mellitus and from hypertension. Case study suggests that patient is diagnosed with symptoms due to poor
management. Other symptoms show fatigue ,itchy skin and swollen legs. Results after physical examination indicated patient is obese and suffering
from Oedema. Blood test analysis indicated patient is suffering from metabolic acidosis and hyperkalaemia. (Townsend,2015) mentioned that Chronic
kidney disease is resulted due to high blood pressure and presence of type 2 diabetes mellitus condition. This indicates blood sugar levels were too
high in patient and this could result in damaging other organs present in the body like heart , nerves, eyes and kidneys etc. From medical history it
shows patient managed with sufferings poorly and as a result of this there are chances of getting stroke , heart attack and kidney disease. One of the
main reasons for patient suffering from chronic kidney disease is due to rise in blood pressure (Cañadas-Garre et.al,2018). Nephrons are lost due to
diffusion and progression of chronic kidney disease is observed irrespective of causes. Activation of Renin angiotensin aldosterone system by initial
filtration will result in causing proteinuria(A condition where larger amounts of protein present in urine).Inflammation of glomerulus and tubules followed
by fibrosis is observed due to uptake of protein and Angiotensin (He et.al,2017).Glomerulus filtration rate declines slowly and this leads to several
complications. Due to imbalances with electrolytes and metabolic disturbances glomerulus filtrate rate starts declining slowly and it progress towards
causing chronic kidney disease. Kidneys fail to secrete potassium present in urine, and it leads to arrhythmias and this condition is referred to as
Hyperkalaemia (Vanholder et.al,2018).