Renal Case StudyA 26-year-old felt puffy, weak, and tired for several months. She suddenly noticed her urine had a red to brown discoloration and the volume was minimal. She went to the emergency room of a nearby hospital and the following data were obtained upon examination and testing:Hematology:Serum sodium125 mEq/LSerum potassium6 mEq/LSerum creatinine2.6 mg/dLBUN24.0 mg/dLpH (arterial)7.32Hematocrit25%Urinalysis:AppearanceRed to brownSpecific gravity1.025BloodPositiveGlucoseNegativeProteinTraceRenal Function Tests:GFR (glomerular filtration rate)40 mL/minRBF (renal blood flow)280 mL/min What is the disorder of this individual?What condition(s) predispose an individual to this disorder?Define hyponatremia and hyperkalemia.What is the cause of the hyponatremia in this patient?Why is there blood in the urine?How do the renal function tests for this individual compare to normal?What caused the puffy feeling?What type of treatment does this person need?Is this person a candidate for kidney dialysis? Explain your answer.

Urinary system is an organ system which is involved in filteration of blood , formation of urine and finally it's removal. It comprises of:- I ) Kidney II ) Ureter III) Urinary bladder IV) Urethra 1) a ) If we look at creatinine level in the blood , it is much more than the normal. Normal value lies in between 0.5 to 1.7 but level of creatinine is 2.6 mg in case of patient . High creatinine level in blood indicate that kidney is not filtering creatinine . b ) Similarly , glomerular filteration rate indication the functioning of kidney to filter up blood . Patient has low GFR ( normal value is 115 to 125 ) . Low GFR means kidney is not functioning properly So , high creatinine and low GFR indicate kidney failure. 2) Some of predisposing factor that leads to such disease can be obstruction in ureter , renal tumor , infection in kidney. 3) a ) Hyponatremia:- Hyponatremia is formed of three words :- Hypo+ natrium + emia Hypo means low ; Natrium means Sodium ; Emia means condition So , Hyponatremia is a condition in the sodium level in the blood decrease. b ) Hyperkalemia Hyper means more ; kale means potassium while emia means condition So , Hyperkalemia is a condition in which potassium level in the blood is high .4)a ) In case of this patient , aldosterone hormone is not working well due to kidney failure. b ) As a result of this , sodium ions are not properly absorbed . Ultimately, sodium level in blood fall . 5) Any structure damage and obstruction in glomerulus or glomerulonephritis results in appearance of blood in the urine of patient . 6) Renal function test gives information about two parameters: GFR and RBF . a ) Normal RBF level is approximately 1200 but patient has low RBF level that is 280 mL / min . b ) Normal GFR level is approximately 115 to 125 mL / min but patient has low GFR that is 40 mL / min.7) Low GFR and RBF cause fluids to accumulate inside the tissue. So , fluid retention results in edema,swelling and puffiness . 8 ) Possible treatment :- a ) Intake of low protein diet so that more waste nitrogenous products cannot produce . b ) Use of diuretics removes excess of accumulated fluids from the body . 9) Dialysis is performed for treating end - stage kidney disease . If kidney disease remains stable , there will be no need of dialysis. If condition worsen ( kidney will not remove metabolic waste of its own ) , then dialysis is required .