Renal function Case study

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Question Description

Disorders of Renal Function

Fred, a fit and healthy 44-year-old, was working outside one warm summer afternoon. When he returned home by the end of the day, his lower back felt sore and he felt nauseated. His wife made him dinner, but he was not hungry and chose to go to bed instead. Fred’s symptoms progressed, and soon he was rolling on the bed with excruciating pain. He said his back hurt as well as his stomach and groin area. The pain would ease off only to return a short while later, and when it did, Fred would begin to sweat and run to the bathroom to vomit. His wife became concerned and started the car. When his symptoms abated, she helped him into the car and rushed him to the hospital.

  • At the hospital, an abdominal radiograph showed the presence of renal calculi in Fred’s right ureter (urolithiasis). What is the mechanism of stone formation in the kidney? What is the role of citrate in the kidneys?
  • Why would the administration of calcium supplements be useful for a patient with calcium oxalate stones?
  • Hydronephrosis can be a complication of renal calculi. What is hydronephrosis? How does back pressure occur in a kidney, and what physiological mechanism is responsible for nephron damage when back pressure is present?

Case Study Posting Requirements

  • Make sure all of the topics in the case study have been addressed.
  • Cite at least three sources; journal articles, textbooks, or evidenced-based websites to support the content.
  • All sources must be within five years.
  • Do not use .com, Wikipedia, or up-to-date, etc., for your sources.
  • Your assignment must be at least 4 full pages of analytic content not counting the cover and reference pages. APA is required.
  • Never use sites such as Mayo Clinic, WebMD, or even Cleveland Clinic since their material is almost entirely focused on the general population, and written at the 8th grade level.

Tutor Answer

School: Duke University



Disorders of the Renal Function




Disorders of the Renal Function
Case Scenario
One warm summer afternoon, Fred, a 44-year-old male in good physical shape was
exercising, and when he got home later in the day, his lower back started aching as well as he felt
nauseated. He did not take dinner that had been prepared and went straight to bed. His symptoms
worsened, and soon, he was in severe pain. Fred’s back, stomach, and groin area hurt, and the
pain would reduce for a short time and come back. He also sweated profusely. He was rushed to
the hospital where abdominal radiograph tests were conducted on him.
The Mechanism of Stone Formation
The formation of renal calculi is a complex process since the stone disorder is a
polygenic, multifactorial disease that requires an interconnection between the bone, kidney, and
the intestines (Falony, 2018). This process occurs in various stages that include supersaturation,
nucleation, and formation of crystals, crystal aggregation, and finally crystal retention.
Supersaturation and Metastable Zone
Renal calculi occur from a complex chemical and physical process that involves two
conflicting forces. The first one is the urinary supersaturation (SS) that facilitate a force for the
formation of stones while the other one is the urinary inhibitor that protects from stone
formation. Urinary supersaturation leads to the change of phase from dissolved salt to the solid
phase. SS implies that the concentration of the salt that forms stones surpasses is solubility and
once this concentration has been achieved, and then there is the formation of the nuclei of its
solid state (Falony, 2018). In urine, the SS c...

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