This is the results from a blood electrolyte analysis from a patient with chroni
ID: 3477597 • Letter: T
Question
This is the results from a blood electrolyte analysis from a patient with chronic renal failure. The kidney is not working properly and nephrons have been lost. Reference Range (normal range) 90-120 mol/l 3.2-4.3 mmol/l Marks allocated 2 marks 3 marks 450 mol/l 4.9 mmol/l 17.5 mmol/l 1.8 mmol/l 2.1 mmol/l 22 g/l 101 g/l Creatinine HCO3 22-31 mmol/l Calcium Phosphate Albumin 2.10-2.50 mmol/l 0.75-1.35 mmol/l 39 - 47 g/l 120-160 g/l 3 marks 1 mark 1 marks Hb Discuss these values with respect to given reference ranges and outline what kidney processese may be affected to produce these results. In your answers you can assume that only kidney function is affected. Hint: the sections with brackets are related and are best discussed together. tExplanation / Answer
Creatinine is a waste product of the muscle and is used as a marker for proper kidney functioning. This waste is excreted in the urine under normal physiological condition. A high creatinine indicates poor filtration rate in kidney and poor excretion capacity of nephrons.
Bicarbonate is used to determine the pH of blood which indicates acidic (pH <7) or alkaline (pH >7) nature. When bicarbonate (HCO3-) is low it leads to metabolic acidosis. This will contribute to hyperkalaemia (increased K+ concentration) since the patient's kidneys are unable to excrete K+. This is due to impaired kidney function.
In patients with low kidney function, phosphate is not excreted properly. Hence high phosphate is seen in blood. These phosphate binds with free calcium in blood and hence decrease its value. The bound phosphate and calcium will remain deposited in the blood vessels.
An impaired kidney will no longer produce erythropoetin. Erythropoetin controls RBC production and low erythropoetin leads to anemia. Thats why low hemoglobin is observed in the patient.
Hypoalbuminaemia (low albumin) is observed in the patient. This may be due to high water retention or excessive loss of sodium by poor kidney function.
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