Factors That Affect The Prognosis Of Cirrhosis

Doppler pulses for her lower right leg are very weak and absent in her right foot. Doppler pulses for her left leg are present (no mention of strength) and weak in her left foot. Pathology results, either from admission to prior too, show Mrs Jones has a serum creatinine level of 221mmol (potentially indicating renal failure (…) )and a blood glucose level of 29.8mmol. Elevated levels of creatininne indicate a lower glomerular filtration rate (the flow rate at which fluid is filtered through the kidneys) and as a result a decreased capability of the kidneys to excrete waste products. Mrs Jones morning finger-prick blood sugar level was

2. Which of the lab values gives you information about how Mrs. Burroughs’ kidneys are functioning?

Often times we may ignore the signs our body is trying to tell us. Mainly due to fear of the unknown. Our kidneys play an important role in our body. They are used to filter out waste through urination. There are many exams that physicians use to help diagnose renal failure and there are some less commonly used because they have no effect of diagnosis of renal failure. Ultra- sounds are the number one imaging modality to help in diagnosing renal failure and angiography of the kidney is the least used imaging modality. In order to prevent our body from shutting down it is imperative we pay attention to the signs of what our body is trying to tell us.

Based on 2014 hepatic encephalopathy guideline, NA’s hepatic encephalopathy is classified as type C and recurrent due to the cirrhosis and 2 episodes of HE occur with a time interval of 6 months or less. Typical signs and symptoms consistent with his HE includes confusion, forgetfulness, and anxiety. According to the guideline, the goals for the treatment are maintaining two to three bowel movements per day, decreasing elevated ammonia level, prevention of recurrent episodes of HE, and improvement of daily functioning. Lactulose is the first choice for treatment of overt HE. Currently, patient is on lactulose only once a day because of his noncompliance. The dose frequency is incorrect since he does not have at two to three bowel movements per day. Increasing frequency back to three times a day is recommended for the patient. Moreover, rifaximin is an effective add-on therapy to lactulose for prevention of OHE recurrence. Also, counseling the effects of lactulose and rifaximin, importance of adherence, early signs of recurring HE, and actions to be taken if recurrence are also beneficial for the patient.

If George was in the second stage of chronic renal failure, what percent of his nephrons have been lost? What changes will be seen in the GFR; urination; and percent of nephrons lost when George reaches end-stage renal failure?

Cirrhosis is the 12th leading cause of death in the United States. Cirrhosis affects one of the largest organs in the body, the liver. It is a condition that slowly worsens the liver and is unable to function normally due to chronic injury. Cirrhosis consists of four stages with the fourth stage being the most advanced stage of cirrhosis. When healthy liver cells are damaged and replaced by scar tissue (fibrosis) it’s known as a degenerative disease called cirrhosis. Chronic alcoholism is the leading cause of cirrhosis due to excessive drinking of alcohol, which causes the liver to swell. In sequence with alcoholism and hepatitis C, or alone obesity can be a risk factor in developing cirrhosis. Cirrhosis of the liver is a disease that can affect many individuals if the condition is not caught in early stages it can become deadly.

A nonprobability sampling was utilized. The creatinine level was checked before the participant took part in the study. The study participants had a similar socioeconomic status, same genetic homogeneity, and several years of formal education.

Wilson disease has a range of clinical manifestations, from an asymptomatic state to fulminant hepatic failure, chronic liver disease with or without cirrhosis, neurologic, and psychiatric manifestations. Often, the diagnosis is not made until adulthood, despite manifestations of the disease beginning to develop in childhood. Hepatic Wilson disease should be considered in the differential diagnosis of any unexplained chronic liver disease, especially in individuals younger than 40 years. The condition may also manifest as acute hepatitis. Hepatic dysfunction is the presenting feature in more than half of patients. The 3 major patterns of hepatic involvement are as follows: (1) chronic active hepatitis, (2) cirrhosis, and (3) fulminant hepatic failure. The most common initial presentation is

1.   According to your lab manual, in humans the glomerular filtration rate (GFR) ranges from _____ to _____ ml/minute.   80

failure can be found by a rise in serum creatinine concentration or azotemia, which is a rise

Cirrhosis with types I or II HRS on top of chronic kidney disease or acute kidney injury.

The biology of a human body consists of multiple systems which function continuously since birth until death, and these sophisticated functions are those which kept a single human being to continue living. The examples of the systems are the excretory system, the endocrine system, and the cardiovascular system. To carry out the complex process of life, some organs have multiple functions in different, interrelated systems, and an example of these multifunctional organs is the kidney. The kidney is an appendage of the human body that works on many vital functions including the excretory system, the endocrine system, and control of body electrolyte and fluid equilibrium. When something wrong happens to the kidney, the impact will be big and the disease will be very complex due to its building structure. In this study, the discussion of the disease is facilitated by dividing them into those that affect its four parts; namely glomeruli, tubules, interstitium and blood vessels. Irrespective of whatever the causes that might take place, chronic kidney disease, more commonly abbreviated as CKD, ultimately cause damage on all four components of the kidney. This leads to the final result of end-stage renal failure (ESRF) (1).

Increase in serum creatinine (SCr) by > 0.3 mg/dl (> 26.5 µmol/l) within 48 hours. OR

All subjects were given two urinalysis sticks and instructed to drink a pint of water at the beginning of the lab period. Then, each subject would go to the restroom using their first dipstick and hold the strip under the flow of the urine. Next, their urine contents were measured by comparing the colors of the individual pads against the standards provided. The color of each urine sample was also recorded. The time was also recorded to observe how long it took for each subject to urinate again after they finished the pint of water. Each subject used the restroom a second time, using a new dipstick, and evaluated their urine contents again.

According to Sushrut Waikar, “Every year more than 1 million hospitalizations in the United States are complicated by acute kidney injury, accounting for an estimated $10 billion in excess costs to the healthcare system.” Acute Renal failure is the inability of your kidneys to work properly. Your kidneys lose the ability to remove waste, filter and balance fluid and electrolytes. This type of renal failure happens most often when there is an injury or trauma and blood flow to kidneys is severely compromised. A person can return back to normal after having acute renal failure, that is if you detect the problem and treat it on time. There are three causes prerenal, intrarenal and postrenal. In prerenal there is a sudden and drastic drop in blood pressure which can result in no blood flow to your kidneys also dehydration can be a part of it as well. Intrarenal occurs when the damage being done is directly to the kidneys. This can happen from the overuse of medications. Medications are not bad when used correctly but when you overuse or don’t use them correctly they can be very harmful to your kidneys. Postrenal is when there is an obstruction in the urinary tract most often from renal calculi or an enlarged prostate in men that blocks the flow of urine.