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Stubborn Grandma Mimi

Acid-Base Balance in Chronic Kidney Disease


Author(s)

Sheri L. Boyce
Department of Biological Sciences
Messiah College
sboyce@messiah.edu

Abstract

Twenty-year-old “Drew” observes his grandmother “Mimi” decline as she stubbornly refuses treatment for her chronic kidney disease. Students examine some basic markers of declining renal function and predict which acid-base disorder Mimi has, as well as the expected compensation. When Mimi develops pneumonia, an existing acid-base disorder becomes life-threatening. Students examine her lab results and explain the changes in pH, PCO2, and bicarbonate levels. This case study was written for a two-semester anatomy and physiology course taken by nursing, nutrition, athletic training, and other allied health majors in their first or second year. It could also be adapted for use in a high school anatomy and physiology course, or an upper-level physiology or pathophysiology course.


Objectives

  • Describe the relationship of blood urea nitrogen (BUN) and serum creatinine to reduced GFR in kidney disease.
  • Explain how impairment of renal function leads to metabolic acidosis.
  • Predict the effect of metabolic acidosis on blood pH, PCO2, and bicarbonate levels.
  • Describe the role of the respiratory system in compensating for metabolic acidosis.
  • Explain the effects of a mixed respiratory and metabolic acidosis on blood pH, PCO2, and bicarbonate levels.
  • Describe the relationship of azotemia and uremic frost to kidney disease.

Keywords

Acid-base; kidney disease; renal impairment; uremic frost; azotemia; acidosis; alkalosis; blood urea nitrogen; BUN; creatinine; glomerular filtration rate; GFR

Topical Areas

N/A

Educational Level

Undergraduate lower division

Format

PDF

Type / Methods

Directed, Interrupted

Language

English

Subject Headings

Physiology  |   Medicine (General)  |  


Date Posted

12/30/2019

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