End Stage of Kidney Disease
Introduction
The kidneys, liver, and the pancreas are some of the most important organs in the body. The proper functions of the kidneys are to remove wastes, filter blood, create urine and control electrolytes. The pancreas is located behind the stomach, it is about six inches and part of it is joined to the first unit of the small intestine. The liver however is positioned on the right side of the belly. The liver is separated into two parts; the right and the left lobe. Both the liver and the pancreas work as one in order to digest food in the body. However, the liver also has something in common with the kidney, which is filtering blood. The liver cleans blood from the digestive parts before it heads to the body.
Friday afternoon on a rainy day at exactly 10:00 am a 63-year-old female was rushed into the ER complaining of chest pain and reported that she has been feeling weak for the past few weeks. Looking at the patients’ medical history it stated that she is a heavy smoker, has an insufficient production of insulin, chronic liver disease, and some tenderness in her joints. After running a thorough echo cardio and physical test, it came to show that she has a heart problem and a long standing of kidney disease. Continuing with the tests, it was proven that she some discoloration of the skin and the white part of her eyes, and various bruises. Her lab results showed some abnormalities in her CBC count, vitals, blood gasses, hormones, low vitamins, and stool and urine sample.
Body
Sodium and calcium are both important to the human body. Sodium helps control the amount of water in and out of the cells. Calcium helps building strong bone and teeth, and also essential for the heart. The patient’s low sodium level or hyponatremia was due to the elevation of her ADH levels that was causing more water retentions. A normal sodium level should be around 135-145mEq/L, whereas the patient’s sodium level that was 126 mEq/L. Signs of low Na can differ from one individual than the next, but in this patient’s case her symptom was that she has been feeling weak for past three weeks. Having that the patient is older, and the echocardiogram reported some abnormalities in her kidneys, these reasons are enough to lower her sodium count. In addition, low calcium or hypocalcemia is the lack of calcium that didn’t interchange from bones to the blood. The dysfunction of the kidneys is one of many cause that can cause the calcium level to be low and certain medications can do that as well.
First and foremost, anemia is the lack of red blood cells count in the human body. The kidneys play an important role in red blood cells. In order for the bone marrow to produce red blood cells, the kidneys have to release the erythropoietin hormone. Therefore, someone that is experiencing a kidney disease may not have the advantage of this hormone and will cause them to become anemic. In order to indicate that she is anemic, a full CBC test needs to be done. The test measure various part of the blood including the hematocrit and hemoglobin levels.
Blood pressure is the force that is being exerted on an artery. A patient with 90/64 mmHg, or lower means that the patient is hypotension. Blood pressure problems can be caused if the heart is not functioning properly. People of all ages can have hypotension, but it is mostly common in adults. Hypotension causes dizziness, blurry vision and pale skin. In order to establish and maintain the normal blood pressure the patient’s heart needs to contracts and pumps more blood, which will then increase more blood flow in the arteries.
The Patient developed an acidemia disorder. Acidemia is an increased concentration of acid in the blood. The increase of Acid will incapacitate the body. The kidney will then try to repay by emitting extra acid in the urine. The more acid that’s being produce is the more overthrow the body will be which will then lead to abnormalities in the heart and will cause acidosis.
The ADH hormone helps the kidneys manage the levels of fluid in the body. The normal variety for an ADH is 1.5. ADH hormone increases the rate of more urine to produce. High glucose or hyperglycemia mellitus means that the person is diabetic. Diabetes mellitus causes blood sugar to increase.
The patients lack vitamins D, K, E, and A is first due to her anemia, which is the lack of red blood cells in her body, her damaged kidneys, and her metabolic disorders. The fact that the patient has a smoking history that can also lead to her low vitamins. When you smoke, it intrudes with the interest of nutrients like the antioxidant vitamin. Chronic illness like a kidney disease can also be the cause of vitamins deficiency.
Due to the low calcium in the patient blood stream, the body would elevate the parathyroid hormone in order to increase calcium level in the body. The PTH hormone releases calcium in the blood.
The liver the biggest and the most important organ of the body. Therefore, any little malfunctions in the liver cause serious problems as it is proven in this patient case. Liver diseases are a serious condition that affect the cells and causes the liver to stop functioning and may lead to these symptoms. Yellow skin and sclera, bruises easily, feeling kind of weak, and having excessive fluid in the tissues of the body means that the patient has a liver disease that’s called liver cirrhosis. That is a condition when the liver Is malfunctioning.
Abnormal color of stool means that there is something in either the live or the pancreas. Bile salts is release into the stool by the liver. A normal stool color should be brown. Therefore, a stool that has a gray or clay color simply means that there’s an infection in the liver that is decreasing the amount bile. The patient also had increased fat content in her stool. When there is an increased of fat in stool that’s called steatorrhea. This is caused by the lack of nutrients absorption in the body, or not enough production of bile in order for the food to digest. However white urine color can be caused by a dysfunction in the kidney, infection, or can be due to a medication. The cause of Sara’s abnormal stool and urine can be a problem in her liver since she spent most of her life smoking her organs are having some malfunctioning. The abnormal function of the liver can lead to edema because the normal blood flow through the liver has slowed down and that leads to problems in the vein that’s supposed to bring blood from the intestine to the liver which then causes the leg and the stomach to be swollen.
Conclusion
In conclusion, the lab results of the sixty-three-year-old female that came into the ER showed various abnormalities due to the malfunctioning of her organs and lack of cells in her blood. Due to the malabsorption in the patient’s nutrients it caused her stool to have lots of fat and even changes color from normal brown to a gray or clay color. Her long smoking history and kidney disease caused her to be extremely low on vitamins. The increasing of acid in her system led to her having heart problem and will even become acidosis. Having heart problem will enables the abilities that the heart needs to contract the arteries in order to maintain a normal blood pressure. Her CBC’s are abnormal due to the kidney that is not able to produce cells by the red bone marrow.
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Reference
Sarah, L. (2018, April 12). Function of pancreas. Retrieved May 20, 2018,
from https://www.lovescience.org/44772-pancreas.html
Pedro, Shannon. (2015, June 16). Kidney Failure. Retrieve from May 19, 2018,
from www.medicical.edu/kidney_failure/.htm.
Medline Plus, Acidosis., (2016). Retrieved on May 20, 2018 from
https://medlineplus.gov/ency/article/0291181.htm
