Question

3. In patients with End Stage Renal Disease (Chronic Renal Failure) without treatment, what lab values would you expect? Why? Type of Expected Why Lab Value (Increased, Decreased, Normal) Potassium (K ) increased Sodium (Na2+) Calcium 1 (Ca²+) Phosphorus (P) Chloride decreased (CI) Magnesium (Mg?) Red Blood Cell Count (RBC) Blood Urea Nitrogen (BUN) Creatinine increased increased

Answer 1

In ESRD the following levels are increased

• Potassium :the kidneys eliminate the potassium lack of this gradually leads to increased potassium
• Phosphorus : lack of excretion done by the kidney
• Magnesium:poor renal excretion
• Chloride:due to problems in tubular reabsorption
• Creatinine :The end product as a result of muscle activity is the creatinine, it has to metabolized in the kidney .Lack of this leads to continuous release and increased creatinine levels
• BUN:It is the end product of protein. The nitrogen cannot be eliminated effectively causing raise on BUN

The following levels are decreased

• Sodium :when the kidney are not able to filter out the excess and waste fluids it accumulates in the body and dilutes the blood resulting in decreased sodium
• Calcium:One of the function of kidney is to convert the vitamin D to calcitrol. This is required for calcium formation. When calcitrol cannot be formed then calcium cannot be formed resulting in decreased calcium levels
• RBC:Erythropoietin mechanism is affected leading to decreased RBC causing anemia