When there is retained urine, Obstructive uropathy occurs.

Obstructive uropathy is a blockage or

obstruction in the urinary tract. When urine is retained, it creates back pressure in the urinary
system, that may cause atrophy in tubules and fibrosis in the interstitial tissue as a response, that
may further damage the kidneys, which is why we came up with our 2nd nursing diagnosis, and
why the patient was prescribed with folic acid. To prevent any deficiency caused by the
dysfunction of the kidneys.
After the kidneys are damaged, there various functions of the kidney that are also expected to be
disturbed such as the inability to remove excess fluid, inability of the kidneys to remove acid.
And when this happens, it can lead to a condition known as metabolic acidosis. The kidneys will
also be unable to filter, that may result to leakage of protein, Kidneys filter blood through
glomeruli, but if these structures are damaged, proteins can leak into urine, and given na may
history of DM si patient, mas nadadagdagan yung factor na naapektuhan yung integrity ng
filtration barrier. If the kidneys are damaged, there will also be an inactivation of vitamin d.
When vitamin D becomes inactive, the body may respond by increasing the production of
parathyroid hormone (PTH). This hormone stimulates the release of calcium from bones and
reduces calcium excretion by the kidneys. The imbalance in calcium regulation contributes to
hyperparathyroidism, leading to elevated serum calcium levels.
because of too much urine retained, there will also be a buildup of toxins that may lead to
increased levels of toxins. increased toxins hinder the kidneys' ability to sense low oxygen levels,
leading to decreased erythropoietin production, as evidenced by the decreased levels of
Hemoglobin of the patient (118/l). decreased erythropoietin production results in reduced
stimulation of the bone marrow, which can be seen on the decreased platelet of the pt (130/l).
Erythropoietin is a hormone that normally signals the bone marrow to produce red blood cells.
With lower erythropoietin levels, there is a diminished signal to the bone marrow, leading to
decreased red blood cell production and contributing to anemia in CKD patients.