Please enable JavaScript.
Coggle requires JavaScript to display documents.
An elderly female patient has a history of osteoporosis, chronic type 2…
An elderly female patient has a history of osteoporosis, chronic type 2 diabetes, and high blood pressure.
Upstream
Osteoporosis
Osteoporosis and Kidney disease come hand in hand, as those who have kidney disease will end up having osteoporosis. The kidney is unable to filter out the vitamins and minerals in the blood such as vitamin D. Vitamin D is needed to allow for bone strength.
Diabetes Mellitus Type 2
DM 2 can cause a decrease in kidney function, as the high glucose in the blood can cause damage to the blood vessels. Also when one has diabetes, diabetic neuropathy can be a complication from diabetes. Over time, poorly controlled diabetes can cause damage to the blood vessels and can also lead to high blood pressure. Diabetic Kidney disease can be seen due to the increase excretion of albumin and glucose in the urine.
Hypertension
One of the main roles of the kidney is to increase or decrease the blood pressure. The kidneys produce different hormones that help either increase or decrease blood pressure in the body. The kidney reabsorbs the hormone aldosterone, which increases the blood pressure in the body. Aldosterone is closely linked to two other hormones: renin and angiotensin, which create the renin-angiotensin-aldosterone system, This system is activated when the body experiences a decrease in blood flow to the kidneys, such as after a drop in blood pressure. Renin is responsible for the production of angiotensin, which then causes the release of aldosterone.
Renal Hypertension is caused by a narrowing in the arteries that deliver blood to the kidney. When the kidneys receive low blood flow, they acts as if the low flow is due to dehydration. So they respond by releasing hormones that stimulate the body to retain sodium and water, this the causes the blood vessels to fill with additional fluid, and blood pressure goes up.
Downstream
-
-
-
-
-
If nothing changes, what will happen to the patient
If all these conditions are not treated or if the patient does not regulate these conditions, they can cause the kidneys to become damaged over time. Damage to the kidneys over time causes the kidneys not to be able to properly function, which means that the kidneys are unable to filter the blood or regulate blood pressure. If the kidney is not treated, the kidney can start to fail and lead to needing a kidney transplant or being on dialysis for a long period of time.
-
-
Structure of a Nephron
- The microscopic filtration unit of the kidney is called the nephron
- the bulbous region of a nephron located within the renal cortex is called the renal corpuscle
- the renal tubule portion of the nephron is composed of the proximal convoluted tubule, nephron loop, and distal convoluted tubule
- the region of renal tubule originating at the bend in the PCT, consisting of an ascending limb and descending limb, is called the nephron loop
- Nephrons with relatively long nephron loops that extend deep into the medulla aid in the establishment of salt concentration gradients within the interstitial space that allow for the regulation of urine concentration by ADH
- Nephrons drains into collecting tubules, series of collecting tubules drain into collecting ducts, and groups of collecting ducts drain into papillary ducts.
Filtration, Reabsorption, and Secretion of specific molecules
Filtration is the passive separation of water and solutes from the blood plasma within the glomerular capillaries
Tubular reabsorption occurs when components within the tubular fluid move from the renal tubules, collecting tubules, and collecting ducts across their walls and return to the blood within the peritubular capillaries and vasa recta
Tubular Secretion is the movement of solutes out of the blood within the peritubular and vasa recta capillaries into the tubular fluid
Osteoporosis, DM 2, and Hypertension
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. The loss of bone occurs silently and progressively.
Diabetes Mellitus Type 2: is a chronic condition that affects the way your body metabolizes sugar. With DM 2, your body either resists the effects of insulin or doesn't produce enough insulin to maintain normal glucose levels. DM 2 develops when the body becomes resistant to insulin.
Hypertension: is when the blood pressure is abnormally high and is greater than 120/80 mmHg. Hypertension can cause damage too many different organs and can be caused by multiple reasons.