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.

2. Describe the clinical effects you would expect during the final stage of disease, when kidney failure develops. Explain the significance of each of Mr. Stone’s physical complaints?

Answer 1

Answer-during chronic renal disease, patient will develop oligouria due to decreased gfr. Patient may also have disturbed calcium metabolism, due to which he may suffer from osteomalacia or osteitis fibrous cystica. Increase urea creatinine in the blood causing bleeding problems leading to petechial hemorrhage. Anemia may occur due to deficient erythropeoietin. Increased blood urea and nitrogen, causes altered sensorium. Increased blood pressure, due to dysregulation.