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An elderly female patient has a history of osteoporosis, chronic type II…
An elderly female patient has a history of osteoporosis, chronic type II diabetes mellitus, and high blood
pressure. She has come to the doctor today because she has noticed blood in her urine.
Background Information
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Function- the kidneys filter blood and convert the filtrate into urine. This liquid waste is then transported by the ureters from the kidneys to the urinary bladder that stores the urine until it is eliminated through the urethra.
Structure of a nephron- the microscopic filtration unit each consists of a renal corpuscle and a renal tubule 
Glomerular filtration- passively seperates some water and dissolved solutes from the blood plasma within the glomerular capillaries. this seperated fluid is called filtrate which is essentially plasma minus large solutes.
Tubular reabsorption occurs when components within the tubular fluid move my membrane transport processes from the lumen of the renal tubules, collecting tubules, and collecting ducts across their walls and return to the blood. generally all vital solutes and most water are reabsorbed.
Tubular secretion is the movement of solutes by active transport out of the blood within the peritubular and vasa recta capillaries into the tubular fluid. materials are moved selectively into the tubules to be eliminated from the body.
Osteoporosis- which literally means porous bone, is a disease in which the density and quality of bone are reduced. As bones become more porous and fragile, the risk of fracture is greatly increased.
DM II- With type 2 diabetes, the body either doesn't produce enough insulin, or it resists insulin. symptoms include increased thirst, urination, and hunger.
Hypertention- Common factors that can lead to high blood pressure include: A diet high in salt, fat, and/or cholesterol. Chronic conditions such as kidney and hormone problems, diabetes, and high cholesterol.
How her previous conditions affect her kidneys- diabetes mellitus 2 is going to lead to more glucose not being properly absorbed leading to increased levels in the urine.
Over time, uncontrolled high blood pressure can cause arteries around the kidneys to narrow, weaken or harden.
Other factors include her age and possible medications she could be on due to the high blood pressure and osteoporosis could also be affecting her kidneys
Diabetes affects the kidneys by causing excess glucose that needs to be filtered through leading to the kidneys having to work harder
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Whats likely causing blood in her urine is kidney stones or crystals from minerals caused by the breakdown of bone in osteoporosis or diabetes.
If nothing changes she could develop larger stones or infections in her urinary system. additionally the high blood pressure and diabetes will continue to put pressure on her heart.
these conditions all effect each other because of the amount of minerals and solutes in the blood and urine, as well as the pressure of the fluid (blood) effect filtration and reabsorption in the kidneys