Robert was diagnosed with hypertension at the age of 39. Intaking better care of himself., Robert a former college athletefound himself eating poorly, consuming too much alcohol, smoking,and spending too much time sitting in front of the TV sincegraduating. His personal habits have also caused him to gain asignificant amount of weight. Robert is now on two high bloodpressure medications to try and control his blood pressure. He alsomodified his lifestyle to include regular exercise, stoppingsmoking and moderate alcohol consumption and a sodium diet.
Robert’s, father had died earl from renal failure due tohypertension he took his lifestyle changes seriously. Robert now56, is a triathlon athlete and very competitive and strived tofirst in his age group. In order to gain the edge, he needs, hehired a certified clinical trainer, Carmen. Robert was experiencingdehydration and fatigue while exercising, so he wanted help to finda way to drink enough fluids while training.
Carmen designed a way for Robert to assess his physiologicalstatus (PS)before, during, and after his workouts. A urinalysis wasdone before, right after, and six hours after a two-hour trainingrun to determine his renal status a measure of his PS.
The table below shows Robert’s urinalysis data.
Time | Color | Specific Gravity | Protein | Glucose | pH |
Before | pale yellow | 1.010 | absent | absent | 6.3 |
Immediately after | dark yellow | 1.044 | small amount | absent | 4.4 |
Six hours post | yellow | 1.032 | absent | small amount | 5.2 |
Questions
1. What does the color of Robert’s urine tell him about howconcentrated or dilute it is? How does the urinecolor/concentration relate to the urine specific gravity at thesame time?
2. The urine color and specific gravity can give Carmeninformation as to the hydration status of Robert’s body at threedifferent times. What can she conclude from the information basedon color and specific gravity?
3. Antidiuretic hormone (ADH) regulates the formation ofconcentrated or dilute urine. When is Robert releasing the greatestamount of ADH? Explain your answer.
4 Proteinuria (protein in the urine) after intense exercise isphysiological (normal). However, protein is typically not presentin urine. Why is that?
5. Trace glucose that was found in Robert’s urine six hoursafter his exercise, this concerned Carmen, however, Robert had alarge meal an hour before the urinalysis. How could this affect theglucose in Robert’s urine?
6. Intense exercise can cause lactic acid to accumulate. How canCarmen tell Robert’s kidneys are trying to prevent acidosis?Describe this mechanism.
7. After reviewing Robert’s urinalysis data, do you think heshould drink more water prior to starting his training to make surehe stays adequately hydrated? Explain your answer.
8. One of the medications the Robert takes to control his bloodpressure is called an angiotensin converting enzymeinhibitor (ACE inhibitor), which inhibits the activation ofangiotensin II. What are two of the mechanisms by which angiotensinII targets the kidneys to increase extracellular fluid volume,there are several?
