Clinical case report: chronic renal failure
INTRODUCTION: Patient E. O., a 26-year-old man, resident of Conceição de Macabu, worked as a computer technician. He was admitted to the Hospital Público Municipal (HPM) in the emergency sector after being referred by the Estratégia de saúde da Família (ESF) in your home region. He presented with uremic encephalopathy, cramps, dyspnoea and asthenia. After exams, normal-sized kidneys and an increase in cortical echogenicity were observed, possibly with acute diffuse glomerulonephritis when younger. He was admitted, started dialysis immediately and is waiting for a transplant. AIM: Discussion of real cases in the discipline “Biologia para saúde III” (BioSauIII), in order to bring the study of subjects from the basic cycle to the clinical cycle of undergraduate medical course. Based on the knowledge of the patient's clinical history, we were able to understand what may have triggered the current pathophysiology. MATERIAL AND METHODS: Within the discipline BioSauIII we were referred to visit the Renal Disease Clinic of the county, where the conversation with the patient was held, as well as the study of his medical records. In addition, the case was discussed with the doctor responsible for the patient. Thus, we were able to follow the reasoning for the patient's diagnosis. RESULTS: Nephritic syndrome can be understood as the set of signs and symptoms that show up when an individual has their renal glomeruli involved by an acute inflammatory process. In addition, it has the most frequent cause in pediatrics, the infection by Lancefield Group A hemolytic Streptococcus B. Hemogram results showed Urea 267 mg/dL and Creatinine 17.4 mg/dL, that with the increase in kidney cortical echogenicity and physical examination, pointed to chronic renal failure, possibly attributed to an acute diffuse glomerulonephritis in childhood. CONCLUSION: The patient was being treated with losartan 50mg, an angiotensin II inhibitor. In addition, he was also using methyldopa 500mg, an alpha-adrenergic agonist. He is still being treated with hemodialysis, a procedure that a machine filters the blood, which means, it is part of the work that the sick kidney cannot do. The procedure frees the body of residues harmful to health, such as excess salt and liquids. It also controls blood pressure and helps the body to maintain a balance of substances. The patient's prognosis is for kidney transplantation and he is in the process of controlling hypertension to be able for the transplant. The donor will be his mother, who is compatible.
There was no approval by the ethics committee or signature of a free and informed consent form (ICF), because it was part of learning in a discipline of undergraduate medical course.
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