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Urinary Function Discussion Assignment
Question I
Analyzing the case presented names of the possible types of Acute Kidney Injury. Link the clinical manifestations described to the different types of Acute Kidney Injury.
Mr. J.R. could be suffering from prerenal acute kidney injury. The condition is associated with dehydration that impairs kidney perfusion. The patient’s dehydration resulted from persistent diarrhea and vomiting which are associated with massive fluid loss from the body (Walley et al., 2019). Low fluid volume impaired kidney perfusion resulting in cellular damage. The impaired perfusion affects the brain as well, causing reduced cerebration. Low brain activity causes orthostatic hypotension, whose presentation includes dizziness when standing up, as Mr. J.R. is experiencing. Urinary Function Discussion Assignment Help
Mr. J.R. presents intrinsic acute kidney injury symptoms as well. This kind of presentation includes fever, vomiting, and confusion. The condition results from acute interstitial nephritis caused by reactions to certain drugs. Bismuth sub-salicylate, which the patient ingested, contains salicylic acid that may cause such reactions (Mercado et al., 2019). Therefore, an intrinsic acute kidney injury diagnosis is probable given the patient’s fever, vomiting, and use of Pepto-Bismol drugs.
Question II
Create a list of risk factors the patient might have and explain why.
- Dehydration
Urinary Function Discussion Assignment Help
Dehydration causes multiple physiological changes that increase a patient’s susceptibility to AKI and one of them is hypotension. The condition reduces the amount of fluid available for circulation, impairing oxygen-carrying capacity in the blood. Low perfusion implies lower rates of oxygen transport to organs including the kidneys. Persistent hypoperfusion prolongs cellular hypoxia and cell death. Cellular degeneration in the kidneys comprises AKI. Therefore, dehydration’s fluid loss increases a patient’s propensity of developing acute kidney injury (Divney et al., 2019).
- Hypertension
Several factors result in hypertension in populations of all ages. However, the condition has the highest prevalence of up to 72% in geriatric populations, making it probable comorbidity for Mr. J.R (Divney et al., 2019). The condition results from increased cardiac output or altered peripheral resistance and causes extreme blood pressure in vessels. Major vessels’ endothelium is thick enough to sustain this high pressure but tiny blood capillaries’ walls fail to withstand this change resulting in their damage. The impaired microcirculation interrupts free and hemoglobin-facilitated oxygen diffusion between blood and intracellular space, causing cellular hypoxia and eventual cellular death. Cellular death in kidneys constitutes AKI.
- Cardiovascular disease
Heart disease increases the risk of acute kidney injury as well. The condition is popular across populations because 1 in 4 deaths have cardiovascular etiology. Geriatric populations are the most affected since age-related degeneration increases the risk of cardiovascular complications tenfold (Divney et al., 2019). This prevalence makes the condition possible comorbidity for Mr. J.R. Cardiovascular disease increases the risk of AKI due to its association with hypotension and hypertension. Each condition causes cellular hypoxia in the kidneys which results in injury. Urinary Function Discussion Assignment Help
Question III
Describe the complications that the patient might have on his Hematologic system (Coagulopathy and Anemia) and the pathophysiologic mechanisms involved.
Chronic kidney disease (CKD) impairs multiple physiological mechanisms resulting in complications such as anemia. CKD causes anemia by hindering the production of red blood cells. Red blood cell production is triggered by erythropoietin, which is secreted by the peritubular cells of the kidney and the liver (Lv & Zhang, 2019). This hormone alters the chemical properties of erythrocytes to protect them against destruction and stimulates the stem cells of the bone marrow to produce more. CKD impairs the kidney’s capacity to produce erythropoietin. The amount of erythropoietin secreted by the liver is insufficient to sustain a healthy red blood cell production chain (Lv & Zhang, 2019). A low concentration of the hormone causes a higher red blood cell destruction rate and a lower production rate. This state results in anemia.
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