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Sickle Cell Anemia-Chronic Renal Failure

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In my never-ending quest to understand how everything relates, I stumbled across an interesting question in my brain ^_^ Sadly, my professor has instilled fear in 73 students to ask questions in class due to constant belittlement, humiliation and egotism. ='_http://www.medicinenet.com/kidney_failure/article.htm#tocc In here I read up on the causes of kidney failure and read this: Prerenal causes (pre=before + renal=kidney) causes are due to decreased blood supply to the kidney. Examples of prerenal causes of kidney failure are: * hypovolemia (low blood volume) due to blood loss; * dehydration from loss of body fluid (for example, vomiting, diarrhea, sweating, fever); * poor intake of fluids; * medication, for example, diuretics ("water pills") may cause excessive water loss; and * abnormal blood flow to and from the kidney due to obstruction of the renal artery or vein. A person with sickle cell anemia would have low blood volume even if its caused genetics wise, so would having hypovolemia make an anemia susceptible to renal failure? Since the patient has extreme fatigue, would they be even able to drink fluids at all? what about the energy to masticate? This I think would cause dehydration, another requirement for renal failure. Sickle cells has a tendency to cause blood clots, does this relate to the abnormal blood flow? ~_^ Continuing on the website: What are the symptoms of kidney failure? * In the beginning, kidney failure may be asymptomatic (not producing any symptoms). As kidney function decreases, the symptoms are related to the inability to regulate water and electrolyte balances, to clear waste products from the body, and to promote red blood cell production. Lethargy, weakness, shortness of breath, and generalized swelling may occur. Unrecognized or untreated, life-threatening circumstances can develop. [[[[anemia patient is already exhausted from lack of O2 and has most of the symptoms stated above, can this mask pre-kidney failure?]]]] * Metabolic acidosis, or increased acidity of the body due to the inability to manufacture bicarbonate, will alter enzyme and oxygen metabolism, causing organ failure. [[[[i finally understand why i had to learn acid-base regulation when i read the above bullet. Would this mean patient has respiratory alkylosis which relates to metabolic acidosis?]]]] * Generalized weakness may be due to anemia, a decreased red blood cell count, because lower levels of erythropoietin produced by failing kidneys do not adequately stimulate the bone marrow. A decrease in red cells equals a decrease in oxygen-carrying capacity of the blood, resulting in decreased oxygen delivery to cells for them to do work; therefore, the body tires quickly. As well, with less oxygen, cells more readily use anaerobic metabolism (an=without + aerobic=oxygen) leading to increased amounts of acid production that cannot be addressed by the already failing kidneys. [[[[This bullet would answer my question if a patient with sickle cell anemia will always have chornic kidney failure?? 0_0' ]]] Thank you to all who post up a reply =D

Nurse Kyles, BSN, RN

Specializes in Cath Lab & Interventional Radiology. Has 7 years experience.

I find that the best source for homework like this is my med-surg book. Take that out. Look up sickle cell disease and chronic renal failure. Simply: Sickle cell disease leads to anemia and vascular occlusion in the vessels which leads to acute or chronic tissue injury. Chronic renal failure is caused by decreased perfusion in the kidneys. See the correlation?

Thank you for your reply! Your support has helped me become a nurse =D I even referenced this posting recently since a professor of mine was so critical. :woot: