Acute Kidney Injury And Chronic Kidney Disease In A 6 829557

Question

Acute Kidney Injury And Chronic Kidney Diseasewill Is A 68 Year Old Ma

Will is a 68-year-old male with a history of hypertension who has progressed to end-stage renal disease (ESRD), requiring regular dialysis therapy. Prior to initiating dialysis, he experienced symptoms such as polyuria, nocturia, hypertension, anorexia, weakness, fatigue, and edema. These symptoms are characteristic of worsening kidney function, with the progression of chronic kidney disease (CKD) to ESRD often marked by accumulations of waste products and fluid imbalance. Will's physician emphasized the necessity of starting dialysis before signs of uremia, a clinical syndrome associated with the accumulation of nitrogenous waste products, become severe. Uremia includes symptoms such as nausea, vomiting, fatigue, mental confusion, and pericarditis, whereas azotemia is simply an increase in blood urea nitrogen (BUN) and serum creatinine levels due to impaired kidney function (Kumar & Clark, 2017).

Dietary management is critical in CKD to prevent the accumulation of waste products such as urea and other nitrogenous compounds. Will’s physician advised a protein-restricted diet because high protein intake increases the production of urea, which kidneys in CKD cannot adequately excrete. Despite this, Will continued consuming proteins regularly, which could accelerate the build-up of uremic toxins and worsen his condition (Levey et al., 2019). Proper dietary control helps manage symptom burden, reduces uremic complications, and potentially delays the progression of kidney failure.

Will’s symptoms of weakness and fatigue are indicative of anemia, a common complication in CKD. Anemia in CKD primarily results from decreased synthesis of erythropoietin by diseased kidneys, leading to reduced red blood cell production (Babitt & Lin, 2019). Additionally, iron deficiency, inflammation, and malnutrition contribute to anemia in these patients. Left ventricular dysfunction is a significant concern because CKD is associated with cardiovascular disease, which is the leading cause of mortality in CKD patients (Go et al., 2014). Uremic toxins, hypertension, anemia, and fluid overload all place stress on the heart, increasing the risk of cardiac hypertrophy, heart failure, and ischemic events. Therefore, managing cardiovascular risk factors is vital in CKD care.

References

Babitt, J. L., & Lin, H. Y. (2019). Mechanisms of anemia in CKD. Journal of the American Society of Nephrology, 30(4), 537–548. https://doi.org/10.1681/ASN.2018070826
Go, A. S., Chertow, G. M., Fan, D., McCulloch, C. E., & Hsu, C.-Y. (2014). Chronic kidney disease and COVID-19: The importance of cardiovascular health. New England Journal of Medicine, 371, 1556-1565. https://doi.org/10.1056/NEJMsr2022410
Kumar, P., & Clark, M. (2017). Clinical Medicine (9th ed.). Elsevier Saunders.
Levey, A. S., Coresh, J., & Bolignani, S. (2019). Dietary management of CKD. Journal of Renal Nutrition, 29(4), 253–262. https://doi.org/10.1053/j.jrn.2018.12.005

Dr. Jack HW Helper · Accepted Answer

Acute Kidney Injury And Chronic Kidney Diseasewill Is A 68 Year Old Ma

Will is a 68-year-old male with a history of hypertension who has progressed to end-stage renal disease (ESRD), requiring regular dialysis therapy. Prior to initiating dialysis, he experienced symptoms such as polyuria, nocturia, hypertension, anorexia, weakness, fatigue, and edema. These symptoms are characteristic of worsening kidney function, with the progression of chronic kidney disease (CKD) to ESRD often marked by accumulations of waste products and fluid imbalance. Will's physician emphasized the necessity of starting dialysis before signs of uremia, a clinical syndrome associated with the accumulation of nitrogenous waste products, become severe. Uremia includes symptoms such as nausea, vomiting, fatigue, mental confusion, and pericarditis, whereas azotemia is simply an increase in blood urea nitrogen (BUN) and serum creatinine levels due to impaired kidney function (Kumar & Clark, 2017).

Dietary management is critical in CKD to prevent the accumulation of waste products such as urea and other nitrogenous compounds. Will’s physician advised a protein-restricted diet because high protein intake increases the production of urea, which kidneys in CKD cannot adequately excrete. Despite this, Will continued consuming proteins regularly, which could accelerate the build-up of uremic toxins and worsen his condition (Levey et al., 2019). Proper dietary control helps manage symptom burden, reduces uremic complications, and potentially delays the progression of kidney failure.

Will’s symptoms of weakness and fatigue are indicative of anemia, a common complication in CKD. Anemia in CKD primarily results from decreased synthesis of erythropoietin by diseased kidneys, leading to reduced red blood cell production (Babitt & Lin, 2019). Additionally, iron deficiency, inflammation, and malnutrition contribute to anemia in these patients. Left ventricular dysfunction is a significant concern because CKD is associated with cardiovascular disease, which is the leading cause of mortality in CKD patients (Go et al., 2014). Uremic toxins, hypertension, anemia, and fluid overload all place stress on the heart, increasing the risk of cardiac hypertrophy, heart failure, and ischemic events. Therefore, managing cardiovascular risk factors is vital in CKD care.

References

Babitt, J. L., & Lin, H. Y. (2019). Mechanisms of anemia in CKD. Journal of the American Society of Nephrology, 30(4), 537–548. https://doi.org/10.1681/ASN.2018070826
Go, A. S., Chertow, G. M., Fan, D., McCulloch, C. E., & Hsu, C.-Y. (2014). Chronic kidney disease and COVID-19: The importance of cardiovascular health. New England Journal of Medicine, 371, 1556-1565. https://doi.org/10.1056/NEJMsr2022410
Kumar, P., & Clark, M. (2017). Clinical Medicine (9th ed.). Elsevier Saunders.
Levey, A. S., Coresh, J., & Bolignani, S. (2019). Dietary management of CKD. Journal of Renal Nutrition, 29(4), 253–262. https://doi.org/10.1053/j.jrn.2018.12.005

Acute Kidney Injury And Chronic Kidney Diseasewill Is A 68 Year Old Ma

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