A 37 year old man attended his GP\'s office for a routine pre-employment physica

Question

A 37 year old man attended his GP's office for a routine pre-employment physical following a long period working as a bookkeeper from home. He is Caucasian and on examination appeared in relatively good health, though reported an increase in snoring which was disrupting his sleep. His BMI was 29.4 (92kg) and blood pressure was 130/85. The following biochemistry results were obtained Plasma Urine Result 140 mmol/L 133-143 3.8 mmol/L 3.6-4.6 25 mmol/L 24-32 105 mmol/L 98-108 5.2 mmol/L 3.0-7.0 40 mmis.60-120 Reference Range Result Reference Negativ Negativ Range Na Dipstick Protein Blood Albumin/Creatinin 0.010g

Explanation / Answer

Q8. Metabolic disorder and progression of Kidney disease:

The above metabolic dysfunction shows the patient has a decline in the renal function and increased risk for the End-stage renal disease.

Q2. Recommendation to decrease the likelihood of progression to chronic kidney disease

Medication:

The patient should be administrated with antacids and antiemetics to treat the vomiting, erythropoietin to maintain the red blood cell level and to treat anemia iron supplements. Calcium supplements and phosphate- binding agents to maintain the electrolyte levels. Hypertensive agents should be administered if needed to maintain a normal blood pressure level. Antilipid drugs to control the cholesterol level.

Lifestyle choices:

Maintain the fluid intake. Intake of sodium to replace the sodium losses and restriction of potassium will control the symptoms. Protein restricted diet along with vitamin supplement is necessary. Reduce the body weight and increased level of activity, increased self-esteem decreases the progression of kidney disease.

Other Procedures:

Dialysis is necessary for the excretion of potassium if the potassium restricted diet and medication doesn't work. Regular follow-up and treatment will decrease the progression of CKD.

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