Question

Which medication is indicated for the client with hyperkalemia due to chronic glomerulonephritis? A. Kayexalate (sodium polystyrene sulfonate) B. K-Dur (potassium chloride) C. Cephulac (lactulose) D. PhosLo (calcium acetate)

Short answer

Answer: Kayexalate (sodium polystyrene sulfonate)

Step-by-step solution

Understand hyperkalemia and chronic glomerulonephritis

Hyperkalemia is a condition where there is an abnormally high level of potassium in the blood. Chronic glomerulonephritis is a kidney disease that affects the small blood vessels in the glomeruli, reducing the ability of the kidneys to filter blood and maintain an optimal balance of electrolytes, including potassium. In this case, hyperkalemia is caused by the decreased kidney function due to chronic glomerulonephritis.

Analyze the given medications

We need to evaluate the medication options in relation to their effects on potassium levels and their appropriateness for treating hyperkalemia caused by chronic glomerulonephritis: A. Kayexalate (sodium polystyrene sulfonate) - This medication works by binding to potassium ions in the large intestine, which are then excreted from the body. It helps to lower blood potassium levels. B. K-Dur (potassium chloride) - Potassium chloride is a potassium supplement, used to treat hypokalemia, or low potassium levels. It would not be appropriate for treating hyperkalemia. C. Cephulac (lactulose) - Lactulose is a laxative that works by increasing the amount of water in the intestine, making it easier to pass stool. It is not designed to specifically treat hyperkalemia. D. PhosLo (calcium acetate) - Calcium acetate is a phosphate binder that helps lower phosphate levels in people with kidney disease. Though it can be helpful for those with kidney disease, it does not specifically address hyperkalemia.

Identify the correct medication

From the analysis, the medication that is indicated for the treatment of hyperkalemia due to chronic glomerulonephritis is: A. Kayexalate (sodium polystyrene sulfonate) This medication helps to lower blood potassium levels by binding to potassium ions in the large intestine and promoting their excretion from the body.

Key concepts

Chronic Glomerulonephritis Management

Chronic glomerulonephritis (CGN) is a long-standing kidney condition where the glomeruli, the tiny filters in the kidneys, are damaged. The role of the glomeruli is to filter waste and excess fluids from the blood, forming urine in the process. When these filters are damaged, they lose their ability to perform efficiently.

Effective management of CGN involves several steps, primarily aimed at slowing the progression of the disease and managing symptoms, including electrolyte imbalances like hyperkalemia. The following strategies are often used:

• Control of blood pressure with medications.
• Use of specific medications to reduce proteinuria (protein in the urine).
• Dietary changes, like reducing protein and salt intake.
• Monitoring and treating complications such as electrolyte imbalances.

For hyperkalemia associated with CGN, treatment aims to reduce the high potassium levels to prevent life-threatening complications. Medications such as Kayexalate (sodium polystyrene sulfonate) are used to help remove excess potassium from the body by binding to it in the gastrointestinal tract.

Electrolyte Imbalances

Electrolyte imbalances are common in patients with chronic kidney disease, including those with chronic glomerulonephritis. These imbalances occur when the levels of minerals in the blood that are necessary for the normal function of cells and organs are either too high or too low. Electrolytes include sodium, potassium, calcium, magnesium, phosphate, chloride, and bicarbonate.

Hyperkalemia, an excessive amount of potassium in the blood, is particularly dangerous and requires immediate treatment. Symptoms may include muscle weakness, fatigue, and in severe cases, cardiac arrhythmias that can be life-threatening. Management involves strategies to reduce the ingestion of potassium and increase its excretion. Kayexalate (sodium polystyrene sulfonate) is a key medication in this context that binds to the potassium in the colon and aids in its removal from the body. It is crucial for individuals with electrolyte imbalances to be under medical supervision, as treatment needs to be tailored to the specific imbalance and its severity.

Glomerular Filtration

Glomerular filtration is the first step in the formation of urine within the kidneys. This process involves the passage of water and small dissolved substances from the blood into the glomerulus, a tiny tuft of capillaries in the nephron. The glomerular filtration rate (GFR) is an important measure of kidney function.

Factors that affect glomerular filtration can lead to kidney diseases such as chronic glomerulonephritis, where the GFR may be reduced due to inflammation and damage to the glomeruli. A low GFR indicates poor kidney filtration and is associated with an accumulation of waste products and electrolytes like potassium; this causes conditions like hyperkalemia. Maintaining good blood flow through the glomeruli and managing conditions that put strain on the kidneys, such as high blood pressure and diabetes, are important for preserving kidney function and preventing further decline in GFR.