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Lamy, Wilson

Nov 12, 2020 at 15:42

Case study #1

Acute Kidney Injury

Mr JR is likely to be suffering from acute intrinsic renal disease. The clinical signs of nausea, vomiting, diarrhea and fever are generally found in patients with kidney disease. Body weakness and dizziness are however specific to Acute tubular necrosis. Acute tubular necrosis is caused by the damage of the tubule cells of the kidney (Zarbock, 2017). The cells function is reabsorbing fluid and minerals from urine. Damage of these cells prevent proper filtering of blood in the kidney resulting in accumulation of waste products like creatinine and urea in the blood. The metallic taste in Mr JR’s mouth is because of the high urea and creatinine levels in the blood. Low levels of zinc can also result in a metallic taste in the mouth.

Acute tubular necrosis patients have a history of taking nephrotoxic medications, hypotension or trauma. If a person with a faulty kidney takes a non-prescribed drug, there are bound to be adverse effects. This is because the medication is not correctly filtered in the kidney. There is a buildup of unwanted toxic drugs in the blood. In our case, the patient took Pepto-Bismol over the counter without any prescription from the doctor. Because he had an underlying kidney issue, the drug was not adequately filtered. Therefore, there was an accumulation of the medication in the blood resulting in fever, diarrhea, vomiting and body weakness. Pepto-Bismol is an anti-diarrhea medication. Patients should not take it with kidney conditions because it contains salicylic acid that harms the kidney.

Risk Factors

There is a connection between acute kidney failure and other medical conditions and events. The first risk factor is the intake of non-prescribed drugs. The patient took Pepto-Bismol over the counter to relieve diarrhea without any prescription from a doctor. Pepto-Bismol is not recommended for patients with kidney disease. This is because it contains salicylic acid that is harmful to the kidney. Acids build up in kidneys decreases kidney function while increasing kidney damage.

High blood cholesterol is the second risk factor. It causes clog in blood vessels cutting off the flow of blood to the kidneys. This can result in loss of function and worse, necrosis of the kidney due to the shortage of blood supply (Ostermann, 2018). In our case study, the patient is likely to have high cholesterol levels because of the indication of eating fast foods. This could have been an attribute to the condition of renal necrosis.

Hematologic System Complications

Anemia

Kidneys help in the making of new red blood cells. They do this by producing erythropoietin (EPO) which is a hormone that sends signals to the body to make red blood cells. At the chronic stage of kidney failure, the kidney does not produce enough EPO resulting in low production of red blood cells (Zarbock, 2017).

Coagulopathy

Kidney failure affects platelet production, and function. In an average person, Adenosine diphosphate (ADP) and serotonin are produced to attract platelets. In patients with chronic kidney disease, the ADP and serotonin levels are decreased. This condition is closely associated with anemia because red blood cells also produce ADP to facilitate clotting.

A health kidney is responsible for maintaining fluid and electrolyte homeostasis. Decreased renal functions result in an imbalance of electrolytes in body fluids. Creatinine and urea levels are in increased in the plasma in a patient with CKD. Renal failure also affects the potassium levels at the chronic stage. There are also abnormalities in the ranks of calcium and phosphate.

References

Ostermann, M. (2018). Epidemiology, Incidence, Risk Factors, and Outcomes of Acute Kidney Injury. Core Concepts in Acute Kidney Injury, 3-11. doi:10.1007/978-1-4939-8628-6_1

Zarbock, A. (2017). Acute kidney injury. Amsterdam: Elsevier.