Topic 1: Kidneys: Anatomy and Physiology. Pathology of the urination process.
Clinical situation:
A patient presented to the doctor with general weakness, back pain, leg swelling, and urine discoloration. The patient had a history of hypertension and diabetes, which he had suffered from for eight years. A physical examination revealed blood pressure of 160/100 mmHg and swelling of the lower extremities.
Lab results:
| Indicator | Result | Norm |
| Hemoglobin | 118 g/l | 120–160 |
| Creatinine | 165 μmol/L | 60–110 |
| Urine | 10 mmol/L | 2.5–8.3 |
| Urine: protein | 1.2 g/l | 0 |
| Urine: red blood cell | 15-20 in the field of view | 0-2 |
Instrumental studies:
Ultrasound examination of the kidneys: the size of the kidneys is slightly reduced, the density of the parenchyma is increased.
Kidney biopsy (if performed) : sclerotic elements were found in the glomeruli.
Clinical questions:
1. It is likely to determine the diagnosis.
2. Differential diagnosis parameters Show me .
3. Addition of diagnostic check mark.
4. Treatment strategy working Get out.
5. Prognosis and possible complications. Assess the complications that have arisen.
Case discussion:
The patient's condition, clinical symptoms, and laboratory test changes indicate impaired renal function. Elevated creatinine levels and proteinuria indicate glomerular damage. In such cases, differential diagnosis includes diabetic nephropathy, glomerulonephritis , or hypertensive nephropathy.
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