How does back pressure occur in a kidney, and what physiologic mechanism is responsible for nephron damage when back pressure is present?

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Nov 18, 2022

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Fred, is a fit and healthy 44-year-old young man of Asian American descent. He was working outside one warm summer afternoon. He has recently been laid off from his Tech job and was temporarily working with his brother-in law’s landscaping service. When he returned home by the end of the day, his lower back felt sore and he felt nauseated. His wife made him dinner, but he was not hungry and chose to go to bed instead. Fred’s symptoms progressed, and soon he was rolling on the bed with excruciating pain. He said his back hurt as well as his stomach and groin area. The pain would ease off only to return a short while later, and when it did, Fred would begin to sweat and run to the bathroom to vomit. His wife became concerned and started the car. When his symptoms abated, she helped him into the car and rushed him to the hospital
Analyze this case and respond to the following questions. Your responses should be formatted as an analysis and discussion, in complete sentences and paragraph form. Do not repeat the question, just label your responses with the appropriate number. There should be a separate paragraph for each question. If an item has more than one question, answer each question separately in separate paragraphs. Include a title at the top of the page and maintain proper formatting. 1) At the hospital, an abdominal radiograph showed the presence of renal calculi in Fred’s right ureter (urolithiasis). What is the mechanism of stone formation in the kidney? What is the role of citrate in the kidneys?
2) Why would the administration of calcium supplements be useful for a patient with calcium oxalate stones?
3) Hydronephrosis can be a complication of renal calculi. What is hydronephrosis? How does back pressure occur in a kidney, and what physiologic mechanism is responsible for nephron damage when back pressure is present?
4) Consider the cultural and socioeconomic background of the patient in relationship to the case and disorder. *NEW* Your responses will be evaluated for appropriate writing style and depth of discussion and appropriate references. Avoid brief Q & A responses. Your analysis will be in essay format, and there is no need to repeat the discussion questions in your response. Your case analysis should include the following:
The title of the case
Your responses and discussion of the questions posed. Be sure to go beyond briefly answering the questions. Each prompt should be discussed in a separate paragraph. Do not repeat the prompts in your discussion. Include in text citations for each response paragraph.
Include a textbook and chapter reference at the end of your case analysis.

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