Question

Thomas Stone is a 55-year old banker who developed chronic kidney disease as a result of hypertension. His condition was discovered several years ago, when routine laboratory tests revealed elevated serum creatinine levels, and persistent albuminuria. Since then, he has been taking antihypertensive medications and restricting dietary sodium, but he reported difficulty following the low-protein diet that was also prescribed. Mr. Stone recently visited his doctor with complaints of low urine output and reduced sensation in his hands and feet. He also reported feeling drowsy at work and mentioned that he was bruising more than usual. The examination revealed a 9-pound weight gain since his last visit and swelling in his ankles and feet. Tests revealed that is GFR had fallen to 10 milliliters per minute. Mr. Stone is 5 feet 8 inches tall and normally weighs 160 pounds. 1. Explain how chronic kidney disease progresses in Mr. Stone and what happens to GFR, serum creatinine levels, and albuminuria as renal function declines?

Answer 1

Solution: Chronic kidney disease is characterized by gradual, irreversible deterioration of kidney function. Chronic kidney disease typically progresses over many years without causing symptoms. Patients are often diagnosed late in the course of illness after most kidney function has be lost. The GFR (glomerular filtration rate), which is the rate at which the kidneys form filtrate, serum creatinine levels increase, and the degree of albuminuria, which is the amount of albumin lost in urine daily. As the renal function declines, so do the GFR and albuminuria levels. GFR <15 milliliters per minute = kidney failure.