Managing Symptoms of CKD
Added on 2020-03-04
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Case StudyName of the StudentName of the UniversityAuthor’s Note:
Signs and SymptomsChronic renal failure is a progressive disease that results in inability of the kidney tomaintain normal levels of certain substances such as urea, creatinine, sodium, water,haematocrit and so on. Several risk factors may play part in causing nephron damageultimately debilitating kidney function. However, not all nephrons are damaged and thesurviving ones suffer enlargement due to increased load. Glomerulonephritis may occur in arapid and severe manner leading to end stage renal failure or in some patients it is progressesgradually (Lo et al., 2009). No functionality of the kidney causes rise in systemic bloodpressure and proteinuria. Although initially the nephrons try to adopt cope up for thedamaged ones they eventually fail to do so resulting in uremia. Glomerular filtration rate isenhanced in adapted nephrons. The primary complain of Mr Goodpasture during admission was nausea, malaise, lowmood and pruritus. He suffers from end stage renal disease, hypertension, seasonal rhinitisand depression. His biochemistry results show a marked increase in urea and creatinine inblood resulting from the kidney disease he suffers from. Blood creatinine value isoverwhelming high at 825 micromol/L. Kidney failure is almost always associated withraised urea and creatinine concentration in blood due to retention of the nitrogenous wasteproducts by the kidney. Increased blood urea concentration is a better index for measuring theseverity of acute renal failure, whereas increased creatinine concentration provides a betterindex for chronic renal failure. Hence it is evident that Mr Goodpasture’s condition hasdeteriorated markedly and requires immediate medical intervention to prevent adverseconsequences. The haematology report further shows serious abnormalities in the patient. Thehaemoglobin and red cell count are low and levels of white cell count and neutrophils are
markedly high. This is a clear sign of acute infection associated with kidney failure or certainother conditions. As the patient is a rural sheep farmer and suffers from seasonal rhinitis, hemight be suffering from acute infection. Further, studies have shown that patients sufferingfrom chronic kidney disease have an increased susceptibility towards infectious diseases,probably due to reduced immune function. Kidney is a self-regulatory system that is essential to perform a number ofphysiological functions and maintain normal health. It relieves the body from nitrogenouswaste products, maintains water and electrolyte balance and reduces essential hormones andenzymes. In end-stage kidney disease the chronic gradual loss of kidney function reaches anadvanced stage where extreme measures like dialysis or organ transplant is required tosustain life (Levey et al., 2007). Medical HistoryMr Goodpasture has a medical history of hypertension, end stage renal disease,seasonal rhinitis and depression. As the primary function of the kidney is to filter out wasteproducts from the blood, its functionality hugely depends on the blood pressure, especiallyinside the glomerulus. High blood pressure exerts increased pressure on the vessel walls,stretching them, which eventually scars and weakens the vessel tissues (Coresh et al., 2007).The same phenomenon may occur in the blood vessels of the kidney reducing the ability ofthe nephrons to filter blood properly due to lack of oxygen and nutrients. Studies have shownthat high blood pressure is the second leading cause of kidney disease worldwide. Althoughkidneys themselves are equipped with controlling the systemic blood pressure prolonged highblood pressure renders them unable to control the same, further worsening the situation(Schiffrin, Lipman & Mann, 2007). As the patient was born and raised in a rural communityand suffers from seasonal rhinitis, the allergic syndrome might have play a role in
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