Kidney Function and Orthostatic Hypotension Essay

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Orthostatic Hypotension

Blood pressure is the strength of blood pushing against arteries’ walls as the heart beats. Adults have a 120/80 mmHg e normal blood pressure. The numerator represents the systolic pressure which is the measure of blood pressure during active heart beats while the denominator represents the diastolic pressure, which is the blood pressure during passive heart beats (Low & Tomalia, 2015).

Consistent rise of blood pressure to over 140/90 mmHg results to high blood pressure, medically referred as hypertension which puts an individual on risk of stroke. On the other hand, low blood pressure medically referred to as hypotension occurs when the blood pressure is below 90/60. On the contrary, a drop in blood pressure to below 90/60 results to an inadequate brain air supply which results in light-headedness or dizziness and fainting. Once the body’s is unable to rapidly bring blood pressure back to normal one suffers from hypotension. Different factors can inhibit the body ability to control blood pressure which causes hypotension. Although hypotension is prevalent in some individuals, sever hypotension deprives vital body organs oxygen which could result to organ failure (Ricci, Caterina, and Fedorowski 2015).

There exists three different types of clinical hypotension: postural/ orthostatic hypotension, neurally mediated hypotension, and severe hypotension. According to Low & Tomalia (2015), orthostatic hypotension (OH) is a common cardiovascular disorder that occurs due to persistent decline of systolic/diastolic blood pressure to a low of 20/10 mm Hg upon a change of body position. Blood pressure is not constant and varies according to body activity. Abruptly standing yields a decline in blood pressure and once the body is unable to adjust to normal blood pressure fast enough, orthostatic hypotension can occur. This implies that the cardiovascular system is unable to react to abrupt changes appropriately. Although orthostatic hypotension occurs across all ages, the prevalence increases with age with a high of 30% in senior citizens aged above 70 and 5 % among people aged below 50 years.

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Rivka suffered from orthostatic hypotension.

According to Ricci, Caterina, Fedorowski (2015), neurally mediated hypotension occurs due to a decline in blood pressure associated with prolonged standing. Neurally mediated hypotension is a condition where the brain and heart do not communicate appropriately. A scary and upsetting situation has been identified as a major cause of Neurally Mediated Hypotension. Unlike the Orthostatic hypotension whose prevalence increases with age, Neurally Mediated Hypotension is more likely in children and less likely in adults.…

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…and PH regulation (Subramanya and Ellison 2014). Hormone Aldosterone regulates the levels of sodium and potassium by excretion of potassium and reabsorbing potassium. Consequently, secretion of aldosterone regulates blood pressure and water loss and retention and blood volume. Feehally, et al., (2019) notes that in dehydrated individual, adrenal cortex releases aldosterone which stimulates reabsorption of sodium, creating an osmotic gradient which in turn results to passive water reabsorption. Excessive activity by Rivka with no fluid intake caused dehydration which caused low blood pressure and risk injury to her kidney due to low GFR. Consequently, the release of aldosterone will conserve water retaining reversing the declining GFR and protecting Rivka’s kidneys.

Specific gravity test measure

The urinary specific gravity (SG) is a measure of the solute concentration in urine. SG is an indirect measure of urine osmolality. SG is determined by calculating the ratio of the density of water with the density of urine (Feehally, et al., 2019. Thus, it determines the status of hydration and renal function of an individual. The standard reference range is 1.005-1.030. Dehydration increases urine osmolality hence high levels of SG are reported in dehydrated individuals. Given that Rivka was dehydrated hence her urine would have high solute concentration, her SG….....

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References

Feehally, J., Floege, J., Tonelli, M., & Johnson, R. (2019). Comprehensive Clinical Nephrology Sixth Edition. NewYork:

Elsevier.Low, Phillip A., and Victoria A. Tomalia. 2015. “Orthostatic Hypotension: Mechanisms, Causes, Management.” Journal of Clinical Neurology 11(3): 220–26.

Ricci, Fabrizio, Raffaele De Caterina, and Artur Fedorowski. 2015. “Orthostatic Hypotension: Epidemiology, Prognosis, and Treatment.” Journal of the American College of Cardiology 66(7): 848–60.

Schaeffner, Elke. 2017. “Determining the Glomerular Filtration Rate—An Overview.” Journal of Renal Nutrition 27(6): 375–80.

Subramanya, Arohan R., and David H. Ellison. 2014. “Distal Convoluted Tubule.” Clinical Journal of the American Society of Nephrology?: CJASN 9(12): 2147–63.
 

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