Pre-renal Acute Kidney Injury
Instructions: Response must be at least 310 words written in current APA format with at least two academic references cited. References must be within the last five years. Response must extend, correct/refute, or add additional nuance.
Urinary Function:
1.
This patient’s renal injury can be classified as Pre-renal Acute Kidney Injury due to the presented symptoms. He has been with vomiting and diarrhea for 48 hours, and also was not able to tolerate solids of liquid foods. Pre-renal conditions typically do not cause permanent kidney damage (and hence are potentially reversible) unless hypo-perfusion is severe and/or prolonged. Hypo-perfusion of an otherwise functioning kidney leads to enhanced reabsorption of sodium and water, resulting in oliguria (urine output < 500 mL/day) with high urine osmolality and low urine sodium. Pre-renal causes are often apparent clinically. If so, correction of an underlying hemodynamic abnormality should be attempted. For example, in hypovolemia, volume infusion can be tried, in heart failure (HF), diuretics and after load-reducing drugs can be tried. Abatement of AKI confirms a pre-renal cause.
With this patient we can rule out acute intrinsic kidney failure since the patient hasn’t had any direct trauma to the kidneys. Also, any viruses from the burritos he ate, wouldn’t be sufficient to cause toxins overload in the body. We can also eliminate the possibility of ischemia because he lacks of blood in his stools. (Paller, 2020)
2.
There are numerous risks factors that Mr. J.R. could have, some of them are:
-His advanced age, after 65 years, the kidneys start to show deterioration in their structure and function.
-Gastroenteritis: these clinical manifestations, nausea, vomiting and diarrhea are usually associated with AKI.
-Dehydration: Having an inadequate fluid intake due to his many symptoms (diarrhea, excessive sweating, vomiting, the inability to tolerate solid or liquid foods), makes him vulnerable to kidney damage.
3.
Patients with Chronic Kidney Disease can have many hematological complications due to different reasons, Healthy kidneys produce a hormone called erythropoietin, or erythropoietin for short. When the body senses low oxygen levels, it tells the kidneys to release erythropoietin. This hormone tells your bone marrow to make more red blood cells. More red blood cells in the bloodstream mean more oxygen can be transported. However, if the kidneys are damaged, they may make little or no erythropoietin. Iron is a mineral found in protein-rich foods that helps make hemoglobin, the protein in the red blood cell that carries oxygen. A major source of iron is red meat. Because patients in the early stages of kidney disease are advised to reduce the amount of protein they eat, they may not be getting adequate amounts of iron from their diet. The buildup of waste in the bloodstream can also affect red blood cells. Healthy kidneys filter toxins from the bloodstream but kidneys affected with chronic kidney disease are unable to filter as well as they should. Because the body is unable to get rid of this waste, it remains in the bloodstream where it can shorten the lifespan of the existing red blood cells.
