Noble Ridge, aged 65, is looking forward to retiring from his job…

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Question Answered step-by-step Noble Ridge, aged 65, is looking forward to retiring from his job… Noble Ridge, aged 65, is looking forward to retiring from his job at the local water company. However, he has not been feeling well for quite some time and now struggles to complete the crossword puzzle in his daily newspaper. His partner is also worried, and has noticed that Noble is losing weight, has puffy eyes and swollen feet. On a recent long car journey, Noble’s partner who was driving, had to stop several times at service stations so Noble could urinate (polyuria). After much urging from friends and family, Noble visits his GP who carries out a series of tests, one being a urine test which shows the presence of both glucose (glycosuria) and protein (proteinuria) in Noble’s urine. The GP suspects that Noble has diabetic kidney disease, and this is later confirmed by a subsequent visit to the Urology Department of the local hospital. Noble also learns that he has Type 2 diabetes, an undiagnosed condition that he has had for many years and which has caused the damage to his kidneys. Table 1 shows how kidney function and proteinuria changes over a period of years for people living with diabetes mellitus. Years of living with diabetes    Kidney function (%)    Protein in urine (g/day)         0                                                    100                                 0         1                                                     105                                 0.1          3                                                    132                                 0.2          5                                                   149                                 0.2          7                                                    112                                   0.8         9                                                    107                                   1.6         11                                                   103                                   2.6         13                                                  101                                    3.7          15                                                   98                                    4.8          17                                                   90                                    5.3          19                                                   72                                       5          21                                                   54                                      4          23                                                  42                                     3.4         25                                                  36                                      3         27                                                  26                                     2.7           29                                                  16                                      2.2          31                                                    5                                       1.6                 Table 1: Changes in kidney function and proteinuria in people living with diabetes mellitus. (a) Use the data in Table 1 to plot a computer-generated x-y scatter plot showing the daily loss of protein in urine as a function of the number of years living with diabetes mellitus (choose the graphing option that connects the data points by line). Give your graph a title, choose suitable scales for the axes, and label the axes (4 marks)  (b) Briefly, describe how the levels of proteinuria change with time, quoting values to support your description. (2 marks)  One of the tests carried out at the hospital was to measure Noble’s glomerular filtration rate (GFR) using creatinine levels in his plasma and urine. The values obtained were: Plasma concentration of creatinine: 0.0167 mg/ml Urinary excretion of creatinine: 1.2525 mg/min  (c) Use the values above to calculate Noble’s GFR. (2 marks)  (d) What does Noble’s GFR indicate about the condition of his kidneys and the likelihood that he will require haemodialysis? (2 marks)  (e) Using the data in Table 1, estimate how many years Noble has lived with diabetes mellitus? Assume that his healthy GFR, prior to the development of diabetes mellitus, was 125 ml/min. (2 marks)  (f) Briefly, explain how diabetes mellitus can damage the kidneys. (1 mark)  (g) Briefly, explain why creatinine is used to calculate GFR. (2 marks) Science Health Science HEALTH, SP SK299 Share QuestionEmailCopy link Comments (0)

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