Question

Case Study: Renal Physiology

Learning Outcomes:

Apply physiological and biochemical knowledge to analyze case studies on pathological states.

Communicate biological information effectively in written work.

Apply physiology to relevant societal impacts.

Directions: Please read the provided case study and then answer the following questions. Your answers should be complete and detailed, including all relevant physiological details including hormones and renal control mechanisms. Each answer should be at least one paragraph.

A 24-year-old man visits his primary care physician after suddenly noticing that his urine was reddish-brown in appearance, and volume of urine was minimal. His medical history indicates he has been feeling tired and weak for several months. He states he hasn’t been sleeping well, and he appears puffy in the face. Patient is 5 feet, 9 inches, weight of 248 lb, and blood pressure of 160/100 mmHg.

Laboratory testing:

Hematology:

Serum sodium	125 mEq/L
Serum potassium	6 mEq/L
Serum creatinine	2.6 mg/dL
BUN	24.0 mg/dL
pH (arterial)	7.32
Hematocrit	25%

Urinalysis:

Appearance	Red to brown
Specific gravity	1.025
Blood	Positive
Glucose	Negative
Protein	Mild

Renal Function Tests:

GFR (glomerular filtration rate)	40 mL/min
RBF (renal blood flow)	280 mL/min

What are this individual’s most striking clinical and laboratory findings?

This individual would be mostly likely diagnosed with what disorder?

Name several potential causes of this disorder. Which is likely associated with this patient’s condition, why?

What is the cause of the hyponatremia and hyperkalemia in this patient?

Why is there blood in the urine?

What do the renal function tests tell you about the patient compared to a normal individual?

What caused the puffiness?

What medications would be appropriate to use to treat the increased blood pressure and how do they result in restoration of the normal blood pressure? (At least 3 different medications should be discussed)

Answer 1