Reference no: EM1396719
A 50-year-old man is hospitalized because of sever congestive heart failure. He has edema of the lower extremities. His exertional tolerance is limited by dyspnea and weakness. On the day of admission the following physical and laboratory values are found:
Weight = 80 kg
*Blood pressure = 110/85 mm Hg
*Heart rate = 95/min
*Plasma Na+ concentration = 138 mEq/L
*Plasma K+ concentration = 4.5 mEg/L
Plasma renin concentration = 30 units/L (normal, 2-10)
Urinary aldosterone = 90 micrograms/24 hours (normal, 6-16).
*Hematocrit = 0.45 or 45%
Clearance of PAH and inulin was measured by infusing these compounds intravenously, maintaining a steady plasm concentration of 2 mg/100 ml for PAH and 1 mg/100 ml for inulin. Renal excretin of PAH was 8 mg/min and of inulin was 0.8 mg/min.
The patient was confined to bed and treated with digitalis. On the 5th day the following values were obtained.
Weight = 75 kg
*Blood pressure = 115/82 mm Hg
* Heart rate = 87/min
*Hematocrit = 0.50 or 50%
*Plasma Na+ concentration = 140 mEq/L
*Plasma K+ concentration = 4.5 mEq/L
Plasma rening concentration = 20 units/L
Urinary aldosterone = 45 micrograms / 24 hours
Clearance of PAH and inulin was again determined.
Plasma PAH = 2 mg/100 ml
Urine PAH = 9 mg/min
Plasma inulin = 1 mg/100 ml
Urine inulin = 1.0 mg/min.
Calculate glomerular filtration rate on the:
-day of admission = ______________ and the units are _______________
-day 5 of treatment = _______________ with the same units as above.
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