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Peer 1
Initial Post: Explain what happens physiologically with chronic renal failure and the GFR. Support with evidence. Include important labs that are monitored in the process.
Renal failure can be acute or chronic and is usually secondary to hypercalcemia. (McCance, 2019) In this case study the patient has had impaired kidney function since the age of 8 years old, which is now in a chronic stage. Chronic renal failure is caused by a progressive decline in all kidney function, ending with terminal kidney damage. While this is happening adapting and modulating going on in the still-functioning GFR, they are trying to keep the kidneys functioning as normal as possible. There are four phases of chronic renal failure: Reduction in excretory function, reduction in incretory renal function, over hydration and disruption of electrolyte balance, and toxic organ damage because of urinary excreted metabolites. (www.lecturio.com) Labs that are checked are urine sample that will show blood in albumin and the kidney function test that look for waste products and measures that glomeruli filtration rate. (www.niddk.nih.org)
Response #1: Explain the role of Angiotensin II and proteinuria as they relate to advancing renal disease
The role of angiotensin II and proteinuria as they relate to the advancing renal disease is that angiotensin II receptor blockers reduce blood pressure and proteinuria, further trying to protect renal function and delaying the onset of end-stage renal disease. (Beje Thomas, 2020).
Response #2: List at least three other body systems that are impacted by chronic kidney disease and why.
There are many body systems that are impacted by chronic kidney disease, but the three that I chose were the cardiovascular system, the blood system, and the circadian system. The Cardiovascular system decreases the function of the kidneys and increase the patients risk of having a stroke or a heart attack. The blood system slows down the production of the hormone erythropoietin, which eventually leads to anemia and iron deficiency, which would then lead to shortness of breath and fatigue. The circadian system is also impacted by the renal system. It disrupts the natural sleep cycle, making it hard for the patient to fall or stay asleep at night. (www.laminatemedical.com)
References:
Beje Thomas, M. (2020, June 26). Proteinuria Medication: ACE Inhibitors, Angiotensin II Receptor Antagonists (ARBs), Diuretics, Loop, Diuretics, Thiazide, Aldosterone Antagonists, Selective, Calcium Channel Antagonists. Retrieved November 14, 2020, from https://emedicine.medscape.com/article/238158-medication
McCance, K.L., Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children. St. Louis, MO: Elsevier.
Lecturio. (2020, October 02). Chronic Kidney Disease (CKD) – Pathophysiology and Diagnosis. Retrieved November 13, 2020, from https://www.lecturio.com/magazine/chronic-renal-failure/
Effects of Kidney Failure on Body Systems. Retrieved November 13, 2020, from http://www.laminatemedical.com/2017/01/11/effects-kidney-failure-body-systems/
Peer 2
Chronic renal failure is a condition of the kidneys that decreases their ability to filter waste and excess fluids from blood. It is commonly known as chronic kidney disease or CKD. The condition is developed over a long period of time, some symptoms include high blood pressure, anemia, nerve damage and heart problems (Chronic Renal Failure «, 2019). The disease is mainly caused by two other conditions: diabetes and high blood pressure. Diabetes causes too much glucose in the blood, high levels of sugar damages the kidney filters. The damage causes the blood to be overcome with waste and extra fluid (Causes of Chronic Kidney Disease, 2021). High blood pressure damages the blood vessels in the kidneys. The damaged blood vessels restrict blood flow to the kidneys and overtime they stop doing their job properly. The extra waste in blood causes an even higher blood pressure (American Heart Association, 2016).
The glomerular filtration rate is a test that checks the function of the kidneys by measuring the blood passing through the glomeruli every minute. (Khatri, 2018) Glomeruli are filters in the kidneys. This test is the best way to identify kidney disease early on.
American Heart Association. (2016, October 31). How High Blood Pressure Can Lead to Kidney Damage or Failure. Www.Heart.Org. https://www.heart.org/en/health-topics/high-blood-pressure/health-threats-from-high-blood-pressure/how-high-blood-pressure-can-lead-to-kidney-damage-or-failure
Causes of Chronic Kidney Disease. (2021, May 14). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/causes
Chronic Renal Failure «. (2019, December 30). Ada. https://ada.com/conditions/chronic-renal-failure/#:%7E:text=Chronic%20renal%20failure%20is%20a,chronic%20kidney%20disease%20(CKD).
Khatri, M. K. (2018, January 9). What Is a Glomerular Filtration Rate (GFR)? WebMD. https://www.webmd.com/a-to-z-guides/glomerular-filtration-rate