URINALYSIS CASE STUDY Olivia Clements Ray Nelson Alexis

URINALYSIS CASE STUDY Olivia Clements Ray Nelson Alexis Beykke Lily Harvey

CASE STUDY #6 • A 60 -year-old woman comes in for her annual physical. Even though she usually has a lot of energy, she has been unusually tired for the past few weeks. She occasionally feels dizzy and she is finding it harder to sleep through the night. Her ankles and feet are swollen and her face looks a bit puffy. She frequently feels a burning pain in her lower back, just below the rib cage. She has noticed that her urine is darker in color lately. Preliminary workup shows she has elevated blood pressure. Some red blood cells are present in her urine.

OBSERVED SYMPTOMS • Fatigue, possibly due to her lack of sleep • Swelling in the face and joints of the feet • Elevated blood pressure • Dizziness and difficulty walking • Dark colored urine

URINALYSIS RESULTS • Color: yellow • Clarity: cloudy/chunky • p. H: 5. 0 • Specific Gravity: 1. 020 • Protein: 300 (3. 0) +++ • Glucose: negative • Ketones: trace (0. 5) • Blood Cells present

DIAGNOSIS Diagnosis: • Stage 3 of Chronic Kidney Disease § A GFR test would need to be conducted to determine exactly how far along she is Differential Diagnosis: • Urinary Tract Infection § Checking for bacteria in the urinary tract can rule out this option • Kidney Stones § An abdominal x-ray can rule out any possibilities of obstruction

STAGE 3 KIDNEY DISEASE • In stage 3 of CKD, the kidneys have moderate damage done to them already. • Symptoms of stage 3 CKD include § Fatigue § Fluid retentions and swelling of the extremities § Changes in urine, including color change due to red blood cells in the urine, and foamy/chunky urine § Kidney pain felt in the lower back § Sleep problems due to pain and muscle cramps

PLAN • Further testing § GFR testing can be done to make certain that the diagnosis is correct § In stage 3 CKD there is a moderate decrease in filtration (30 to 59 m. L/min) § MRI or CT scan to see the extent of the damage • Treatment options § There is no cure for CKD, but a healthy diet can help preserve kidney function and overall health. § Blood pressure medication can help preserve kidney function, and keeping the glucose levels of the blood at normal range can slow the progression of kidney disease § Kidney dialysis is not necessary yet, but should be taken into consideration in the GFR continues to drop

BIBLIOGRAPHY • https: //pltw. instructure. com/courses/227763/assignments/4365450#submit • http: //www. medicinenet. com/urinary_tract_infection/article. htm • http: //www. renal. org/information-resources/the-uk-eckd-guide/stage-3 -ckd • https: //www. mayoclinic. org/diseases-conditions/blood-in-urine/basics/causes/con 20032338 • https: //www. davita. com/kidney-disease/overview/stages-of-kidney-disease/stage-3 of-chronic-kidney-disease/e/4749