Ms. Cornwall is admitted with pyelonephritis. She has chills, and her temperature is 101°F. She is complaining of flank pain, frequency, and dysuria. Her urine has white blood cell casts and shows growth of Escherichia coli (E. coli).
Based on the above scenario, answer the following questions:
- Why does she have bacteria and white blood cell casts in her urine? Include the pathophysiological response of body for your analysis.
- What are the differences when comparing prerenal acute renal failure, intrarenal acute renal failure, and postrenal acute renal failure? Give examples of each and pathological processes related to each disease process.
Expert Solution Preview
Introduction: Pyelonephritis is an infection of the kidney, commonly caused by bacteria such as Escherichia coli. It is a serious condition that requires appropriate medical attention. Acute renal failure is a common complication of pyelonephritis, which is characterized by the sudden loss of kidney function. In this context, this response will address the pathophysiological response of the body to pyelonephritis and the differences between prerenal, intrarenal, and postrenal acute renal failure.
1. Why does Ms. Cornwall have bacteria and white blood cell casts in her urine? Include the pathophysiological response of the body for your analysis.
Bacteria and white blood cell casts in the urine are symptoms of pyelonephritis. In this condition, bacteria invade the renal parenchyma and cause an inflammatory response. The inflammatory response leads to the migration of white blood cells to the site of infection, causing the casts to form in the urine. The bacteria and inflammatory response can also cause damage to the renal tubules, impairing the ability of the kidney to filter waste products from the body.
2. What are the differences when comparing prerenal acute renal failure, intrarenal acute renal failure, and postrenal acute renal failure? Give examples of each and pathological processes related to each disease process.
Prerenal acute renal failure occurs when there is a decrease in blood flow to the kidneys, leading to impaired renal function. Common causes of prerenal acute renal failure include hypovolemia, sepsis, and dehydration. Intrarenal acute renal failure is caused by direct damage to the renal parenchyma, which impairs the ability of the kidney to filter waste products. Common causes of intrarenal acute renal failure include pyelonephritis, glomerulonephritis, and acute tubular necrosis. Postrenal acute renal failure occurs when there is an obstruction to the urine flow, which causes pressure to build up in the kidney and impairs its ability to filter waste products. Common causes of postrenal acute renal failure include urinary tract obstruction and prostate hypertrophy.
In conclusion, pyelonephritis is a serious condition that can lead to acute renal failure. Understanding the pathophysiological response of the body to pyelonephritis and the differences between prerenal, intrarenal, and postrenal acute renal failure is crucial for appropriate medical management.
