1

Running Header: Urinary Disorders

Urinary Disorders
Jonathan Bland
Pathophysiology
Prof. Lori McGowan

2
Running Header: Urinary Disorders

Mr. Smith, aged 60 years, had hypertension for almost 20 years. Recently, his legs and feet
are swollen, his weight has increased, headaches are frequent, he feels tired, and has lost his
appetite. His blood pressure is 160/105, and he has elevated blood creatinine and urea levels. His
urine is diluted. His hemoglobin is low, serum bicarbonate is low, and serum sodium is low.
Has he developed nephrosclerosis? The patient with the above signs and symptoms has
developed nephrosclerosis. It is the hardening of the blood vessels in the kidneys. The patient is
gaining weight and edema because of the underlying problems that nephrosclerosis presents. The
kidneys no long function properly due to the harden blood vessels. The kidneys blood flow is cut
short of its normal outputs. The patient slowly starts to develop edema because the fluid that
should be going out of the blood is getting backed up. That fluid should be dumped off at the
kidneys for excretion but the nephrosclerosis slows the blood flow down and the blood doesnt
get filtered correctly. The patient is voiding dilute urine because the abnormal function of the
principal cells in the distal part of the nephron. Another reason that with decreased blood to the
nephrons stimulates the renin-angiotensin-aldosterone to give way to systemic vasoconstriction
and also sodium and water retention occurs. This increases blood volume therefore leading to
increased blood pressure. The kidneys are not working correctly so the patient gets dilute urine
when he voids.
The patient develops anemia because the blood is being backed up and the red blood cells are
not returning to the heart to get oxygen. The metabolic acidosis occurs when the patient goes into
renal failure. His kidneys are excreting more acid and increasing bicarbonate absorptions.

3
Running Header: Urinary Disorders

The treatment should start with antihypertensive agents, diuretics, angiotensin-converting

enzyme (ACE) inhibitors, and beta-blockers (which block renin release) all can assist in
maintaining renal blood flow and reducing blood pressure (Gould, 2006).

Works Cited

4
Running Header: Urinary Disorders

Fervenza, F. M. (2010, Feb 25). Nephrosclerosis. Retrieved March 25, 2011, from eMedicine:
http://emedicine.medscape.com/article/244342-overview

Gould, B. E. (2006). Pathophysiology for the Health Professionals, 3rd Edition. Philadelphia: W.B.
Sauders.