Stubborn Grandma Mimi
Acid-Base Balance in Chronic Kidney Disease
Department of Biological Sciences
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.
- 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.
KeywordsAcid-base; kidney disease; renal impairment; uremic frost; azotemia; acidosis; alkalosis; blood urea nitrogen; BUN; creatinine; glomerular filtration rate; GFR
Educational LevelUndergraduate lower division
Type / MethodsDirected, Interrupted
Subject HeadingsPhysiology | Medicine (General) |
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