The location of Emily's pain and the discoloration of her urine are indicative of a renal disorder. The elevated blood creatinine concentration could indicate a reduction in the glomerular filtration rate (GFR) as a result of the glomerulonephritis, and this reduced GFR could have been responsible for the fluid retention and observed edema. The presence of only trace amounts of protein in the urine, however, was encouraging, and could be explained by her running activity (proteinuria in this case would have been an ominous sign). The streptococcus infection, acting via an autoimmune reaction, was probably responsible for the glomerulonephritis. This was confirmed by the fact that the symptoms of glomerulonephritis disappeared after treatment with an antibiotic. Hydrochlorothiazide is a diuretic that helped to alleviate the edema by (1) promoting the excretion of larger amounts of urine and (2) shifting of edematous fluid from the interstitial to the vascular compartment.
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This ebook provides an introductory explanation of the workings of the human body, with an effort to draw connections between the body systems and explain their interdependencies. A framework for the book is homeostasis and how the body maintains balance within each system. This is intended as a first introduction to physiology for a college-level course.