Case Study 6

Acute Renal Injury and Chronic Kidney Disease

Will is a 68-year-old male with a history of hypertension. Eight months ago, he started regular dialysis therapy for ESRD. Before that, his physician was closely monitoring his condition because he had polyuria and nocturia. Soon it became difficult to manage his hypertension. He also lost his appetite, became weak, easily fatigued, and had edema around his ankles. Will debated with his physician about starting dialysis, but she insisted, before the signs and symptoms of uremia increased, the treatment was absolutely necessary.

What is the difference between azotemia and uremia?
Two years ago, Wills physician told him to decrease his protein intake. In spite of what the physician ordered, Will could not stop having chicken, beef, pork, or eggs at least once a day. Why did his physician warn him about his diet?
Wills feelings of weakness and fatigue are symptoms of anemia. Why is he anemic?
Knowing what you do about Wills history, why is left ventricular dysfunction a concern for his physician?