J.H. is a 12-year-old boy diagnosed with glomerulonephritis thought to be second

Question

J.H. is a 12-year-old boy diagnosed with glomerulonephritis thought to be secondary to a streptococcal throat infection. J.H. had been diagnosed with nephrotic syndrome several months prior to his most recent clinic visit. At his latest clinic visit, a decrease in urine output, increasing lethargy, hyperventilation, and generalized edema are noted. Trace amounts of protein are detected in J.H.'s urine. Blood is drawn for laboratory analysis, which reveals the following: Hct = 30%; Na+ = 130 mEq/L; K+ = 5.4 mEq/L HCO3 – = 15 mEq/L;   BUN = 58 mg/dl;   creatinine = 3.9 mg/dl; albumin = 2.0 g/dl 1. Discuss J.H.'s laboratory values for likely cause and significance (how do they relate to the pathophysiology of nephrotic syndrome)

Explanation / Answer

Answer

The issue is metabolic alkalosis
- hematocrit is low due to erythropoietin and hematuria
- BUN and creatinine are high because he cannot filter
- patient has azotemia and anasacara due to low albumin

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