Question

A 60-year old African American patient is newly diagnosed with mild chronic kidney disease (stage 2). She has a history of diabetes, and her current A1C is 8.0. Which of the following factors could contribute to the development of her kidney disease?

1) She heavily salted her food as a child and teenager but added no extra salt as an adult.
2) Her chronic hyperglycemia causes blood vessel changes in the kidney that can damage the tissue.
3) Her paternal grandparents had type 2 diabetes and hypertension.
4) She drinks 2 cups of coffee with cream daily.

Answer 1

The development of chronic kidney disease in the patient is primarily influenced by chronic hyperglycemia causing damage to the kidney's blood vessels and a family history of type 2 diabetes and hypertension.

Step-by-step explanation:

The factors that could contribute to the development of her chronic kidney disease include chronic hyperglycemia, which can damage the blood vessels in the kidneys due to the high levels of glucose in the blood, particularly in the glomerular capillaries (diabetic nephropathy). This damage can lead to kidney tissue injury. Additionally, a family history of type 2 diabetes and hypertension can also increase the risk for kidney disease.

While the patient's past dietary habits of heavy salt consumption and daily coffee consumption may be relevant to overall health, the most direct contributing factors include the patient's poorly controlled diabetes, as indicated by her A1C level of 8.0, and her family history of diabetes and hypertension.

These are critical elements that intensify the risk of progressing from mild chronic kidney disease to more advanced stages.