In a patient with chronic kidney disease, sodium retention and hypertension is most likely a sign of:

Question

In a patient with chronic kidney disease, sodium retention and hypertension is most likely a sign of:

BlackTom AI · Accepted Answer

The question asks about a presentation in a patient with chronic kidney disease (CKD): sodium retention and hypertension. This pattern most strongly points toward a glomerular source of CKD. 
Option 1: Glomerular disease. In CKD of glomerular origin, loss of functional nephrons reduces filtration, triggering compensatory mechanisms such as the renin–angiotensin–aldosterone system (RAAS), leading to sodium and water retention and the development of hypertension. This is a classic and well-recognized association. 
Option 2: Interstitial disease. While interstitial nephritis or fibrosis can contribute to CKD, sodium retention and hypertension are not as specifically characteristic as with glomerular disease. Interstitial processes can cause tubulointerstitial damage and impaired concentrating ability, but they do not classically produce the same RAAS-driven volume retention pattern seen with glomerular disease. 
Option 3: Tubular nephropathy. Tubular dysfunction often leads to defects in concentrating ability, electrolyte wasting, or Fanconi-like syndromes, depending on the tubule segment involved. Sodium wasting rather than retention is more typical in many tubular disorders, so hypertension driven by sodium retention is less a hallmark feature here. 
Option 4: Acute tubular necrosis. ATN is an acute process and, although it can cause acute changes in renal function, it is not a characteristic cause of chronic sodium retention and long-standing hypertension in the CKD setting. The question emphasizes chronic kidney disease, where ATN is not the typical underlying pattern. 
Overall, the pattern of chronic sodium retention and hypertension aligns best with a glomerular pathology, making the glomerular disease option the most consistent choice given the scenario.

PHYS30010_2025_SM1 CAL 3: Renal Failure

In a patient with chronic kidney disease, sodium retention and hypertension is most likely a sign of:

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