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End-Stage Kidney Disease

Rev 12-17-17

Physiology: Signature Assignment

For your signature assignment, compose a 3- to 4-page case analysis (in addition to a

title, abstract, and a reference page) written in APA format with at least 3 references,

with one non-Internet reference.

The following should be covered in the paper:

• Title page: Case title, full name, section, date, instructor, and campus

• Abstract: Summarize the case.

• Introduction: Explain the physiological importance of the liver, pancreas, and

kidneys for the proper functioning of the human body.

• Body: Respond to the prompts. Organize your analysis with headings that

thoroughly answer the prompts (e.g., “Calcium and Sodium Imbalance” should be

the heading for question 1).

• Conclusion: Summarize the paper in a paragraph.

By submitting this paper, you agree to the following: (1) you are submitting your paper to be used and

stored as part of the SafeAssign services in accordance with the Blackboard Privacy Policy; (2) your

institution may use your paper in accordance with your institution’s policies; and (3) your use of

SafeAssign will be without recourse against Blackboard, Inc., and its affiliates.


Rev 12-17-17

End-Stage Kidney Disease

Sarah, a 63-year-old female with a past medical history significant for diabetes mellitus,

cirrhosis, gout, and a 30-pack a year smoking history presents to the emergency room

with chest pain revealing pericarditis in the echocardiogram, secondary to recently

diagnosed end-stage renal disease. Physical examination reveals yellowish

discoloration to the skin and sclera, multiple bruises, 2+ bilateral edema, and weakness

lasting more than three weeks. Her medications include Glisten, a new drug for diabetes

that causes ATP sensitive potassium channels to close, thereby releasing insulin. Her

recent laboratory results are as follows:


Sodium 126 mEq/L

Glucose 220 mmol/L

Calcium 7.1 mg/dl

Red blood cell count 3.9 cells/ul


Blood Pressure 92/64 mmHg

Blood Gases

pH 7.28

CO2 30 mmHg

HCO3 12 mmol/L Hormone Panel

Renin Low

ADH Elevated

Aldosterone Low Vitamins

Vit D Low

Vit K Low

Vit E Low

Vit A Low Urine and Stool Sample

Stool color Gray

Stool content Increased Fat Content

Urine color White

Rev 12-17-17

Please address each of the following regarding Sarah’s case:

1. Explain the cause for her low calcium and sodium levels.

2. Explain the cause of her anemia. What laboratory test should indicate she is

suffering from anemia?

3. Explain the cause of her hypotension. How will her body attempt to establish


4. What type of acid-base disorder has she developed, and how will her body


5. Explain the cause of her elevated ADH and glucose levels.

6. What is the correlation between her illnesses and the low vitamins (D, K, E, and

A), renin, and aldosterone levels?

7. Which hormone would the body elevate in response to her low calcium levels?


8. Explain the physiological reason behind her physical findings (yellowish hint of

the skin, sclera, multiple bruises, weakness, and edema).

9. Explain the cause of her abnormal stool and urine sample.

10. What cell does Glisten work on? Explain how this medication is able to stimulate

insulin secretion.

Support your opinions with evidence from your readings and research. Review the rubric for complete grading criteria.

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