Case Scenario 1
Age is an essential factor in the diagnosis of proteinuria. In the case scenario, the patient is twelve years, and it is necessary to consider that factor the protein levels in is urine and establish whether it is normal, low, or high. “In children <2 years of age, the normal upper limit of the Upr/Ucr is 0.50; in children >2 years of age, it is 0.20. The Upr/Ucr correlates well with 24 h urine protein excretion” (Gul et al., 2017). Therefore, the physician should concentrate on measuring the protein levels of the child and establish whether it can be associated with the sour throat and the swollen leg. Huether & McCance (2017, p.761) indicated that “intrarenal microcirculator vasoconstriction occurs in response to injury and inflammation.” The patient may have been injured in the leg, explaining the inflammation, and it may have been a risk factor for proteinuria.
Case Scenario 2
The twenty-three-years old patient is suffering from a renal tubular injury. The condition results from ischemia, causing inflammatory responses causing cellular injury and necrosis. A urinary catheter had to be inserted so that the urine output of the patient could be monitored. The urine output of the patient averaged at 15 ml/hr, high urine osmolality, as well as low sodium levels in the urine. “The reported etiology of 50% of those patients with acute renal failure was found to be acute tubular necrosis from ischemia causes, and the other 25% were nephrotoxic acute tubular necrosis leading to renal failure” (Hanif & Ramphul, 2019). Renal insufficient can be noted in the patient. According to Gul (2017, p. 760), “renal insufficient refers to a decline in renal function to about 25% of normal or a GRF of 25 to 30 ml/minute.” It explains the reason the urine output of the patient had to be monitored.
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References
Gül, A., Özer, S., Yılmaz, R., Sönmezgöz, E., Kasap, T., Takçı, Ş., … Bütün, I. (2017). Prevalence of Proteinuria in School-Aged Turkish Children and Its Association with Obesity and Hypertension. The Journal of Pediatric Research , 195–199. doi: 10.4274/jpr.36449.
Hanif, M., & Ramphul, K. (2019). Acute Tubular Necrosis. National Center for Biotechnology Information .
Huether, S., & McCance, K. (2017). Understanding Pathophysiology Elsevier (6th ed.). St. Louis, MI: Elsevier.
