Martha's first patient on the pediatric floor is a 12 year old boy named Sam who is undergoing kidney dialysis
treatment. Sam has been on dialysis for the last week, and the treatments will probably be discontinued because his kidneys are becoming fully functional again. Martha questions Sam's mother concerning his illness. Three weeks ago, Sam had a sore throat which kept him home from school for two days but was not medically treated. One week ago, Sam told his mom his urine looked red-brown and foamy. He was admitted to the hospital. Physical examination revealed costovertebral tenderness and blood pressure of 135/90. The urinalysis and other studied revealed the following: Urinalysis- Color: red-brown-tinged, Specific gravity: 1.030, Red blood cells: numerous per high power field, Protein: > 1g/24 hr, Casts: epithelial cells and red blood cells. Other values: Creatinine: 4 mg/dl, Blood urea nitrogen: 90mg/dl, creatine clearance test: 50 ml/min
What is the nature of the problem? Which of those above are not normal? Explain. How can this be treated?