A 55yearold man with no history of illness suffered a blow t

A 55-year-old man with no history of illness suffered a blow to the head. He was unconscious when admitted to the hospital and remained in that state until his death 15 later. A nasogastric tube was inserted to administer the required nutrients (protein, carbohydrates, fat, minerals, and vitamins). The total water intake was 1, 500 mL/d. Starting on day 5, his blood pressure gradually fell. The 24-hour urine volumes recorded from an indwelling catheter were as follows: The patient\'s hemoglobin and hematocrit were elevated. Blood chemistry analysis on day 13 revealed the following: What is the probable cause of the elevated proteins? What other results support this conclusion? Why is the BUN elevated?

Solution

1. Following may be the probable causes of elevated protein level:

a. Any damage or inflammation in the glomerulus where glomerular filtration occurs. Normally healthy people pass small amounts of protein, but above a certain level indicates for chances of any defect in the filtration process.

b. Protein may come to urine from blood that may come from kidney or urinary pathway.

c.It may be also due to kidney diseases like glomerulonephritis or due to general illnesses like high blood pressure and heart failure.

2. Elevated albumin and BUN levels also support this conclusion.

3. BUN refers Blood Urea Nitrogen. Elevated BUN levels indicate heart failure, dehydration or due to diet with high protein.