F. In her mid-forties, Cindy began to show early signs of diabetic nephropathy (
ID: 3514754 • Letter: F
Question
F. In her mid-forties, Cindy began to show early signs of diabetic nephropathy (kidney disease), consisting of persistent proteinuria, hypertension, and gradually decreasing renal function as measured by chemical tests. She nonetheless felt faicdy.healthy over the next 10 years. At age 55, however, she has noticed becoming increasingly fatigued upon mild physical exertion an time, and in the past two weeks, has vomited on several ocasions. She has increased swelling in her ankles, and Laboratory tests reveal that her kidney disease is now progressing at a much fast is short of breath. She has also become less responsive over the past day or so. er rate: BUN (blood urea nitrogen) 56 mg /dl (normal 10-20 mg /dl) Urinary output-25 cc/ hour (normal 50-60 ce/hour) 1. How is Cat phosphate normally regulated? What is the regulatory hormone? Failing kidneys have a harder time excreting phosphate, and thus blood-phosphate levels tend to rise. What effect will rising blood-phosExplanation / Answer
Ans. 1.
The calcium is regulated in the body by calcitriol, calcitonin and parathyroid hormones. Calcitriol is produced from kidney. When blood calcium level is low, caltriol Increases uptake of Calcium from food and release of calcium from bones. Parathyroid hormone is released by parathyroid gland, it stimulates bone to release calcium, it also increases uptake of Calcium from urine in kidney and increases calcium absorption from intestine. Whereas calcitonin lowers the calcium levels in blood.
Parathyroid hormone lowers the phosphate levels in the blood, it does so by lowering the phosphate reabsorption from urine in kidney causing more excretion of phosphates. Calcitriol raises the level of phosphates in blood by increasing the absorption of phosphates from intestine. Thus calcitriol increases the levels of both calcium and phosphates.
When kidney fails, phosphate is not excreted out and therefore it's level increases in the body which leads to hyperphosphatemia. High phosphates level leads to low calcium levels in blood. It may cause muscle cramps, spasms, numbness, bone weakness, bone and joint pain, increase in risk of heart attack and stroke.
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