Kyri6 Baca MNT 409

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1,2,4,5,6,7,8,12.13. 16. 17. 18.21,24,34,
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Aplil9,2013
Case Study #26RenalDisease/Dialysis:

1.

Physiological Functions of the kidney:

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Fluid, electolyte, organic solute and pH balance Filter 1600L blood/d into 180L ultrafiltrate into 1.5L urine Glomerulus: barrier to RBC and protein Tubules: resorb/excrete fluid, electrolytes, Ff ions, and solutes Eliminate RSL Need 500 ml urine/d to excrete RSL Nifiogen waste (urea uric acid, creatinine, ammonia) Renin-Angiotensin pathway in the regulation of blood pressure Erythropoecyte production: production of RBC in the bone marrow Vitamin D3 activation (1,25(OH)2 Vitamin D) Prostaglandin fonnation/secretion which participates in vascular and systemic inflammation

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2. Uncontrolled Type 2 Diabetes can lead to chronic kidney disease because of the chronically elevated blood sugar, which overloads the kidney. The kidney is responsible for excreting excess glucose in the blood through its mechanism of filtration, but diabetes overuses the kidney's ability of excretion by increasing the amount of blood that needs to be filtered, leading to chronic kidney disease. After yeaxs of damage, the filtration system of the kidney begins to weaken to the point of protein loss, which can lead to microalbuminuria. Early detection of CKD is key, as this disease is insidious and gradually worsens as the patient may or may not know that they are affected. When kidney function reaches the point of dialysis, transplant or continual use of dialysis are

theonlytreatmentoptions.

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Stage 1: over 90 mllmin GFR - kidney damage with normal or increased GFR Can havethe beginning stages of kidney disease without any symptoms or

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w VA. alterations in btoodwoik. [.,rtvrvn aJ,Vil ()ot1l! A Stage 2:60-89 ml/min GFR-mild decrease inkidney function Decrease in GFR No real characteristic symptoms because the kidneys are so good at doing their job even if they are not functioning 100%. Stage 3: 30-59 mllmin GFR * moderate decrease in kidney fimction Significant changes in BUN and creatinine Hyperkalemia &ggy4c,hwt NI At Hypernatremta Stage 4:15-29 ml/min GFR- severe decrease inkidney function Waste products build up in the blood > uremia > uremic syndrome Complications:

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