How the Kidney Works to Excrete Waste

The kidney plays a crucial role in the waste excretion where it filters the blood and removes any unwanted materials. The kidney is also useful in the water level balancing by ensuring that the level of fluids in the body is kept at the right balance. Also, the kidney plays a crucial role in the regulation of blood pressure ( Choi, Park& Ha , 2015). The other key functions of the kidney are in the red blood cells regulation and acid regulation. Pancreas, on the other hand, produces the chemicals that help in the digestion of the foods. The pancreas beta releases insulin hormone which helps in the regulation of the blood sugar levels. The major roles of the liver in the body entail the control of the storage and concentration of nutrients such as fats and vitamins, producing bile and making of the proteins. All these functions are essential in the normal functioning of the body. 

Question 1. Low Calcium and Sodium Levels 

The cause of low sodium levels in the body is due to kidney failure, where the kidney is unable to get rid of the extra fluid from the body. The function of the kidney is to filter the excess wastes and fluids from the blood which is then excreted in the form of urine. The chronic kidney disease can lead to dangerous levels of fluid in the body which lowers the levels of sodium through dilution. Hypercalcemia occurs in people with chronic kidney dysfunction where calcium combines with phosphate thus lowering the levels of calcium in the blood ( Blaine, Chonchol &Levi, 2015 ). As the level of phosphate rises due to kidney failure, the level of the calcium decreases because these two react in opposite ways in the body. Low calcium levels can lead to certain symptoms such as muscle cramps and overall bone weaknesses. 

Question 2. Cause of Anemia 

Anemia occurs when the blood does not have enough red blood cells, which occur when either the body is unable to make red blood cells, or there is an interference with the blood cells in the body. When there is an excessive breakdown of red blood cells, their levels in the blood decreases leading to anemia ( Camaschella, 2015 ). Red blood cells have hemoglobin which helps in the transportation of oxygen to the body tissues. As the red blood cells get broken down, the body tissues are deprived of oxygen. A laboratory test that can be used to determine the presence of anemia is the complete blood count. This test is used to determine the number of red blood cells in a sample of the blood. Other tests for iron deficiency anemia can involve a test for the symptoms such as ulcers and kidney failures. 

Question 3. Cause of Hypotension 

Chronic kidney failure can lead to inability to filter and absorb the excess fluids in the blood. Chronic kidney failure usually results in the breakdown and damage to the blood cells. It also leads to an imbalance as a result of the loss of excess water and electrolyte. The sodium, potassium and other electrolytes in the body gets imbalanced. This excessive loss of water means that as the blood is moving through the blood vessels, it has less water thus small in volume ( Lonardo et al., 2018 ). The outcome is the low blood pressure within the blood vessels. To create an equilibrium, more antidiuretic hormones will be secreted thus calling for the intake of much water to replace the lost water. The water taken will be absorbed to the blood vessels which will then increase the fluid level and take back blood pressure to normal. 

Question 4. Type of acid-base Disorder 

Due to her excessive smoking,the type of acid-base disorder that Sarah can suffer from is respiratory alkalosis. This disorder is associated with an increase in the blood pH and a decrease in the bicarbonate levels. The level of carbon dioxide falls below the normal range leading to a higher pH value. The compensation for this disorder requires a decrease in the reabsorption level for the bicarbonate which will then tend to push the pH towards the normal range ( Adrogué & Madias , 2014). The reduction in the absorption of bicarbonate can alter the equation to shift to the left in the metabolic acidosis thus taking back the pH to normal rates. The retention of bicarbonate via the partial pressure of carbon dioxide effect can create a shift in the pH levels leading to its reduction. 

Question 5. Cause of elevated ADH and Glucose levels 

The major role of the anti-diuretic hormone is to control the fluid volume in the body by reducing the amount of water that is passed out as urine. It functions by allowing urine to get back to the body is a specific section in the kidney where more water is reabsorbed leaving out concentrated urine ( Melander, 2016 ). Kidney failure makes it impossible for the kidney to absorb the excess water in urine leading to the passage of dilute urine with a lot of water. The loss of excess water through urine as a result of kidney failure leads to dehydration. This is detected by the receptors in the heart and blood vessels which stimulate the release of ADH to control the loss of water. Thus the elevation of ADH release is as a result of the increased dehydration which is detected by the nerve cells in the hypothalamus thus stimulating the release of ADH. 

When the kidney is damaged, they cannot filter the blood and remove the excess wastes and sugar. The inability of sugar to filter the blood leads to wastes build-up in the body ( Melander , 2016). Because the kidney cannot remove wastes from the blood, including sugar, the level of sugar rises in the blood leading to type 2 diabetes. Diabetes is a condition in which there is excess sugar in the blood. Also, the glucose levels can be increased by renal disorder due to the destruction of blood vessels inhibiting the transportation of the glucose. 

Question 6. Correlation 

Because Sarah has increased level of fats in the stool, it is an indication that most of the vitamins D, K, E and A are not being absorbed. Any healthy kidney is rich in vitamin D receptors which play a key role in turning these vitamins into their active form. Kidney failures thus result in reduced absorption of vitamin D. Similarly, a low level of vitamin K leads to lower phylloquinone. At the same time, the bile salt entry into the duodenum may be hindered thus the emulsification of the dietary fats becomes incomplete, a condition which arises due to the defective liver (Li et al., 2016). The presence of the fats in her stool is thus as a result of malabsorption that occur due to defective liver. The renin-angiotensin-aldosterone system act as a signaling pathway for the regulation of the blood pressure. The kidney produces renin to regulate blood pressure through the renin-angiotensin-aldosterone system. The damage to the kidney leads to the reduced release of the hormone. 

Question 7. Hormone release for low calcium 

The hormone that will be secreted is the parathyroid hormone from the parathyroid glands. The major role of the parathyroid hormone is to regulate blood calcium levels. Parathyroid hormone is secreted from the thyroid glands, and they help regulate the calcium levels by increasing the hormone whenever it is low ( Evenepoel, Bover & Torres, 2016 ). By acting on the kidney, parathyroid hormone minimizes the loss of calcium in the urine by ensuring that the calcium is absorbed back to the bloodstreams. The hormone is controlled whenever there is negative feedback on calcium. The existence of low calcium levels stimulates the release of the hormone, whereas a high level of calcium leads to a decrease in the parathyroid hormone. 

Question 8. Physiological Reason 

Jaundice, which is the yellowing of the skin and eyes, is a symptom that occurs as a result of the illnesses. The cause is due to the existence of too much bilirubin in the system. Bilirubin is the yellow pigment that develops as a result of the breakdown of the red blood cells ( Mariakakis et al., 2017 ). The condition occurred in Sarah due to the breakdown of the red blood cells as a result of kidney failure. The major reason for jaundice is mainly liver cirrhosis. Weakness results from the loss of strengths in the muscles as a result of the loss of the red blood cells which plays a crucial role in the transportation of oxygen and other nutrients to the muscle tissues. Edema, which is the abnormal accumulation of fluid in the tissues of the body, occurs due to increased blood pressure within the blood vessels, and the inability of the kidney to maintain fluid balance in the body. 

Question 9. Abnormal Stool and Urine sample 

Steatorrhea is a condition in which the stool has too many fats. It occurs as a sign of malabsorption. The body is unable to absorb the nutrients and fats properly. Too many fats in the stools could mean that the digestive system is not breaking down the fats effectively ( Okajima et al., 2016 ). The most common cause of this is the cystic fibrosis. Sarah has an infection in the liver which plays a crucial role in the digestion of fats. It is the liver that produces bile that breaks down the fats into smaller pieces. The change in the color of urine could be as a result of the kidney failure making it unable to filer the wastes from the urine, and this could have been responsible for the change in the color of urine. The kidney is responsible for the excretion of the wastes from the blood. If the kidney cannot function normally, most of the wastes will not be removed through urine thus the different color. 

Question 10. What cell does glisten work on? 

Glisten works on the beta cells to initiate the production of insulin hormone. Insulin is a hormone that is produced by the beta cells located in the pancreas. When taken, the glisten functions on the beta cells to initiate the secretion of insulin hormone ( Velasco et al., 2016 ). Insulin works by making the body to use blood glucose for energy thus reducing the blood sugar level. Most people with type two diabetes do not make enough insulin and require glisten to facilitate the production and take the blood sugar levels to normal range. 

Conclusion 

Sarah who is a 63-year-old woman is suffering from kidney failure, a condition that has led to the rise of many other conditions and diseases. Due to kidney failure, she has also developed diabetes mellitus and liver cirrhosis, the conditions that arise as a result of the inability of the kidney to function normally. She has also experienced high blood sugar level and elevation of the ADH in her blood. Furthermore, Sarah has developed urinary infection due to the inability of her kidney to excrete and filter the wastes from the blood. 

References 

Adrogué, H. J., & Madias, N. E. (2014). Respiratory acidosis, respiratory alkalosis, and mixed disorders.  SPEC-Comprehensive Clinical Nephrology, 12-Month Access, eBook , 169. 

Blaine, J., Chonchol, M., & Levi, M. (2015). Renal control of calcium, phosphate, and magnesium homeostasis.  Clinical Journal of the American Society of Nephrology ,  10 (7), 1257-1272. 

Camaschella, C. (2015). Iron-deficiency anemia.  New England journal of medicine ,  372 (19), 1832-1843. 

Choi, H. Y., Park, H. C., & Ha, S. K. (2015). Salt sensitivity and hypertension: a paradigm shift from kidney malfunction to vascular endothelial dysfunction.  Electrolytes & Blood Pressure ,  13 (1), 7-16. 

Evenepoel, P., Bover, J., & Torres, P. U. (2016). Parathyroid hormone metabolism and signaling in health and chronic kidney disease.  Kidney international ,  90 (6), 1184-1190. 

Li, B. R., Pan, J., Du, T. T., Liao, Z., Ye, B., Zou, W. B., ...& Lin, J. H. (2016). Risk factors for steatorrhea in chronic pancreatitis: a cohort of 2,153 patients.  Scientific reports ,  6 , 21381. 

Lonardo, A., Nascimbeni, F., Mantovani, A., & Targher, G. (2018). Hypertension, diabetes, atherosclerosis and NASH: cause or consequence?.  Journal of hepatology ,  68 (2), 335-352. 

Mariakakis, A., Banks, M. A., Phillipi, L., Yu, L., Taylor, J., & Patel, S. N. (2017). Biliscreen: smartphone-based scleral jaundice monitoring for liver and pancreatic disorders.  Proceedings of the ACM on Interactive, Mobile, Wearable and Ubiquitous Technologies ,  1 (2), 20. 

Melander, O. (2016). Vasopressin, from regulator to disease predictor for diabetes and cardiometabolic risk.  Annals of Nutrition and Metabolism ,  68 (Suppl. 2), 24-28. 

Okajima, K., Nagaya, K., Azuma, H., & Suzuki, T. (2016). Biliary atresia and stool: its consistency and fat content, another potentially useful clinical information.  European journal of gastroenterology & hepatology ,  28 (1), 118. 

Velasco, M., Díaz-García, C. M., Larqué, C., & Hiriart, M. (2016). Modulation of ionic channels and insulin secretion by drugs and hormones in pancreatic beta cells.  Molecular pharmacology ,  90 (3), 341-357.