Healthcare. Student's Name. Institutional Affiliation.

Running head: HEALTHCARE 1
Healthcare
Student’s Name
Institutional Affiliation

HEALTHCARE 2
Part 1
Question 1.1
Kidneys are retroperitoneal organs which are bean-shaped and the center of each kidney
there is an indentation which fits to the hilum of the kidney. They are enclosed by a thin layer of
a thick connective tissue called kidney fascia which clinches the kidney to its surrounding. Also,
a thin layer of fibrous connective tissue, the adipose capsule, is a fatty layer that safeguards the
kidney from injury and the adipose capsule contains a soft, dense, vascular renal cortex. Every
kidney has around one million nephrons and the nephron contains two major parts which are
kidney tubule along with kidney corpuscle (Chalmers, 2019).
Kidneys’ chief function is to excrete waste materials originating from protein metabolism
along with muscle contraction and the glomerulus filters them out of the blood, excreting them
out of the body in urine. The concentrated blood left in the glomerulus capillaries occupies the
efferent arterioles and the peritubular capillaries enclosing the proximal convoluted tubule
(Chalmers, 2019). From the proximal convoluted tubule, the tubular fluid infiltrates the Henle
loop where ion plus water are resorbed. The filtrate passes via the ascending Henle loop limb
while exiting the medulla and the tubular fluid exiting, passes via the distal convoluted tubule
and the collecting nephron duct.
Question 1.2
The renal blood flow rate of relatively 400 ml/100g of tissue per minute is much higher
compared to that observed in the brain, heart, and liver. Subsequently, renal tissue may be
susceptible to a consequential quantity of likely dangerous circulating agents. Even under
physiologic conditions, glomerular filtration is dependent on high intra-glomerular and trans-
glomerular pressure hence the glomerular capillaries become prone to hemodynamic damage (De

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Rosa, Prowle, Samoni, Villa & Ronco, 2019). On that note, glomerular hypertension along with
hyperfiltration is the chief contributor to the advancement of persistent kidney disorder.
Glomerular filtration membrane has negatively charged particles that act as an impediment
controlling anionic macromolecules. With the interference in the electrostatic barrier, plasma
protein gains access to the glomerular filtrate.
The regular arrangement of nephron’s microvasculature along with the tubuli
downstream position concerning glomeruli control the glomerulo-tubular balance and enhances
the glomerular damage spreading to a tubulointerstitial compartment in disorder, revealing
tubular epithelial cells to anomalous ultrafiltration (De Rosa et al., 2019). Furthermore, a decline
in glomerular or preglomerular perfusion results in a decline in peritubular blood flow which
contingent upon the hypoxia level consists of tubulointerstitial damage and tissue reconstruction.
Therefore, the hypothesis of the nephron as a functional unit implores to kidney physiology as
well as to pathophysiology of kidney disease.
Although Melanie was not diagnosed with hypertension, during her examination her
blood pressure was high at 190/110mm Hg. This could be a risk factor for the progression of
Melanie’s condition. Systemic high blood pressure is spread to intraglomerular capillary pressure
resulting in glomerulosclerosis along with loss of renal function, hence variable peril of kidney
function impairment is normally found among hypertensive people (Kazancioğlu, 2013).
Furthermore, age is a risk factor for Melanie as she is now 55 years old. Kidney function
declines with age both in males and females thus the elderly people are more prone to develop
chronic renal failure after several kidney insults.
Anemia is a complication of chronic renal disorder (Bello et al., 2017). It is described as
a decline in one or several of the main red blood cell measurements, that is, the concentration of

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hematocrit, red blood cell count, or hemoglobin. As per Melanie’s blood test results, her
hemoglobin was 95g/L which is lower than normal. Moreover, uremic symptoms which include
fatigue, nausea and pruritus are complications of chronic renal disorder (Bello et al., 2017). This
is evident in Melanie since she got concerned with her feeling of escalated tiredness, general
pruritus, and nausea and then decided to visit her GP.
Chronic kidney disease has no cure but treatment can aid in relieving the symptoms and
stopping its progression. Hemodialysis is a treatment option for Melanie whereby tubes connect
the patient to a machine that filters the blood. It is performed around thrice per week and the
more frequent the sessions the better the quality of life for the patient. Another treatment option
is kidney transplantation (Aimaretti & Arze, 2016). The donated kidney is surgically placed in
the lower abdominal region and replaces the operation of the natural kidneys.
Question 1.3
Acute renal failure (ARF) is an abrupt hike in serum creatinine while Chronic Renal
Failure (CRF) is the gradual loss of kidney performance (Chawla, Eggers, Star & Kimmel,
2014). With ARF, no symptoms at first but with CRF, there are early symptoms like
hypertension. CRF is as a result of long-term disorder while ARF is as a result of an event.
Furthermore, ARF is largely reversible while CRF is often irreversible. ARF develops rapidly
but CRF develops slowly. Lastly, patients with ARF are put on temporary dialysis while those
with CRF are put on permanent dialysis (Chawla et al., 2014).
Question 1.4
Renal replacement therapy replaces nonendocrine renal function in persons with kidney
damage. The objectives of renal replacement therapy (RRT) include correction of electrolyte
abnormalities, solute and water removal along with acid-base disturbances normalization. It is