Aiko Naruto, a 42-year old Japanese who works as an old store manager admitted to the hospital’s intensive care

unit. She was

first seen in the emergency room with severe edema, headache, and a rapid heart rate. She reported an inability to pass more
than minimal amounts of urine in the past two days. Her son, who drove her to the emergency room, reported that she had
missed work for several days and seemed confused and unusually tired. Laboratory tests revealed elevated BUN and potassium
levels. Mrs. Idoko has been diagnosed by the physician with acute renal failure. Mrs. Naruto is low active, 5 feet 3 inches tall and
weighs 125 pounds.

Patient Data:

 Name: Aiko Naruto

 Age: 42 y/o
The National Kidney Foundation states that kidney disease can develop at any time, but those over the age of 60 are more likely than not to develop
kidney disease. As people age, so do their kidneys. More than 50% of seniors over the age of 75 are believed to have kidney disease 2.
However, according to NIDDK, chronic kidney disease (CKD) is most common among people ages 65 or older (38%), followed by people ages 45 to 64
(12%), and people ages 18 to 44 (6%) 3.

 Height: 5’3
 Weight: 125 lbs/ 56.69 kg
 Nationality: Japanese
 Occupation: Old Store manager
 Objective: Severe Edema, Rapid Heart rate
Edema is a common complication of heart failure 2. It is not typically dangerous in itself, but the location and severity of the swelling can be an indicator of
how severe the heart failure is. Some types of edema, such as pulmonary edema, are a medical emergency . Kidney disease can cause fluid and salts in the blood to
build up. Edema linked to kidney disease usually occurs in the legs and around the eyes. Damage to the tiny, filtering blood vessels in the kidneys can result in
nephrotic syndrome .
A rapid heart rate, also known as tachycardia, is not an uncommon symptom of acute renal failure 23. Tachycardia can be caused by a variety of factors,
including dehydration, electrolyte imbalances, and heart disease 4.When the kidneys become impaired, the hormone system that regulates blood pressure goes into
overdrive in an attempt to increase blood supply to the kidneys. The heart then has to pump against higher pressure in the arteries, and eventually suffers from the
increase in workload 5. This can lead to tachycardia and other heart-related symptoms.

 Subjective: Headache, inability to pass more then Minimal Amounts of urine in the past two days. Seemed
confuse and unusually tired.
Acute kidney failure can cause a variety of symptoms, including headaches. However, headaches are not a common symptom of acute kidney failure.
Headaches can be caused by a variety of factors, including dehydration, electrolyte imbalances, and heart disease 4.
One of the most common symptoms of acute kidney failure is a decrease in urine output, also known as oliguria 123. Oliguria is defined as producing less
than 400 milliliters of urine per day, which is less than about 1.5 cups 4.Oliguria can be caused by a variety of factors, including dehydration, electrolyte imbalances,
and damage to the kidneys themselves 12. Acute renal failure can cause oliguria due to damage to the filtering mechanism of the kidneys. This can lead to a buildup
of waste products in the blood and can be life-threatening if not treated promptly 1.
According to the Mayo Clinic, Healthline, and Cleveland Clinic, confusion and tiredness are common symptoms of acute renal failure

 Lab results: Elevated BUN, Elevated Potassium levels

Blood urea nitrogen (BUN) is a waste product that is produced when the liver breaks down proteins. The kidneys are responsible for filtering BUN from the
blood and excreting it in urine. Elevated BUN levels can be an indication of kidney dysfunction or damage. Acute renal failure can cause a buildup of toxins in the
blood, which can lead to elevated BUN levels 1. Causes of elevated BUN in acute renal failure include blood clots in the veins and arteries in and around the kidneys,
cholesterol deposits that block blood flow in the kidneys, and inflammation of the tiny filters in the kidneys (glomeruli) 1.
Hyperkalemia can occur in people with acute renal failure due to impaired urinary potassium excretion caused by acute or chronic kidney disease (CKD)
and/or disorders or drugs that inhibit the renin-angiotensin-aldosterone system (RAAS) 3. It is important to note that hyperkalemia can cause nausea, weakness,
numbness, slow pulse, and can be dangerous. It can also be a sign that dialysis is needed or not working well enough

 Medical Diagnosis: Acute Renal Failure

The Mayo Clinic states that acute kidney failure is a condition where the kidneys suddenly become unable to filter waste products from the blood, leading to
dangerous levels of waste accumulation and chemical imbalances in the blood 1
If you have concerns about your kidney health or are experiencing symptoms of acute renal failure, it’s important to seek medical attention immediately. Symptoms
of acute renal failure may include decreased urine output, fluid retention, shortness of breath, fatigue, confusion, nausea, weakness, irregular heartbeat, chest pain
or pressure, seizures or coma in severe cases 1

 Lifestyle: Low Active

Acute renal failure, also known as acute kidney injury, is a condition that occurs when the kidneys suddenly lose their ability to filter waste products from the blood 1.
While there are many factors that can contribute to acute renal failure, such as dehydration, blood loss, and certain medications, a sedentary lifestyle is not one of
them 12. However, maintaining a healthy lifestyle that includes regular physical activity and a balanced diet can help prevent kidney disease and slow its progression
23.

If you have concerns about your kidney health or are experiencing symptoms of acute renal failure, it’s important to seek medical attention immediately. Symptoms
of acute renal failure may include decreased urine output, fluid retention, shortness of breath, fatigue, confusion, nausea, weakness, irregular heartbeat, chest pain
or pressure, seizures or coma in severe cases 1
 Foods to eat:
Low-protein foods: Apples, berries, grapes, peaches, pears, carrots, green beans, lettuce, onions, and zucchini.
Low-sodium foods: Fresh fruits and vegetables, unsalted nuts and seeds, whole grains, and lean meats.
Low-potassium foods: Applesauce, blueberries, cherries, cranberries, grapes, peaches, pears, pineapple,
plums, raspberries, strawberries, green beans, lettuce, onions, and zucchini.
Low-phosphorus foods: Applesauce, berries, cherries, cranberries, grapes, peaches, pears, pineapple, plums,
raspberries, strawberries.
It’s important to note that these are general guidelines and may not be suitable for everyone. Please consult a
doctor or a registered dietitian for personalized dietary recommendations.

When you have acute renal failure, it is important to avoid foods that are high in potassium,
phosphorus, sodium, or protein 1. Some examples of these foods are:

Dairy products  Potatoes  Artichokes

 Whole-grain bread  Spinach
Alcohol  Beans  Fresh beets
 Nuts  Dates
Oranges and orange juice  Meat  Frozen dinners
 Fish  Seasoned salts
Tomatoes  Deli-style meat  Soy sauce and other
 Processed cheese condiments and sauces
Bananas
 Canned fish

It is recommended to follow a kidney-friendly diet and avoid or limit certain foods to decrease the
accumulation of waste products in the blood, improve kidney function, and prevent further damage
2. The National Kidney Foundation’s most recent Kidney Disease Outcomes Quality Initiative (KDOQI)
guidelines suggest limiting sodium to under 2,300 milligrams (mg) per day, as well as your potassium
and phosphorus intake 2. Damaged kidneys may also have trouble filtering the waste products of
protein metabolism. Therefore, individuals with chronic kidney disease of all stages, especially stage
3–5, should limit the amount of protein in their diets unless they’re on dialysis 2.

If you have kidney disease, it’s important to watch your intake of sodium, potassium, and
phosphorus. Items that contain high amounts include cola, brown rice, bananas, processed meats, and
dried fruits 2. Here are some lists of foods to avoid by food group category 1:

Fruits and vegetables that are high in potassium

Bananas Ccantaloupe Ttomatoes

Oranges Ppears aavocados

Potatoes Rraisins Bbroccoli

Foods that are high in phosphorus

Dairy products Whole grains ooatmeal

Nuts Bbran cereals Ggranola

Foods that are high in sodium

 Processed meats
 Canned soups
 Salted snacks
Please note that this is not an exhaustive list. It’s best to consult with a doctor or dietitian to
determine your personal limits for these nutrients based on lab results 2.