A 56-year-old woman with polycystic kidney disease comes to the office for follow up. Her renal function has been gradually declining, and she is being considered for hemodialysis in the near future. The patient has recently experienced increasing exertional dyspnea and fatigue but has had no fever, dysuria, or flank pain. Other medical conditions include hypertension and renal calculi. Blood pressure is 130/86 mm Hg and pulse is 80/min. Physical examination shows mucosal pallor. The lungs are clear on auscultation and heart sounds are normal. Abdominal examination reveals palpably enlarged kidneys. There is no lower extremity edema. Laboratory results show normocytic, normochromic anemia, which is attributed to insufficient hormone production by the kidneys. This hormone is predominantly secreted by which of the following parts of the kidney?

Question

A 56-year-old woman with polycystic kidney disease comes to the office for follow up.  Her renal function has been gradually declining, and she is being considered for hemodialysis in the near future.  The patient has recently experienced increasing exertional dyspnea and fatigue but has had no fever, dysuria, or flank pain.  Other medical conditions include hypertension and renal calculi.  Blood pressure is 130/86 mm Hg and pulse is 80/min.  Physical examination shows mucosal pallor.  The lungs are clear on auscultation and heart sounds are normal.  Abdominal examination reveals palpably enlarged kidneys.  There is no lower extremity edema.  Laboratory results show normocytic, normochromic anemia, which is attributed to insufficient hormone production by the kidneys.  This hormone is predominantly secreted by which of the following parts of the kidney?

Quizplus · Accepted Answer

Eductional Objective: Erythropoietin (EPO) is produced primarily by peritubular fibroblast cells in the renal cortex in response to decreased renal oxygen delivery (eg, decreased blood hemoglobin content).  EPO acts on erythrocyte precursor cells in the bone marrow to stimulate red blood cell production.  Patients with chronic kidney disease have inflammatory damage to renal EPO-producing cells and often develop normocytic anemia due to insufficient EPO

A 56-Year-Old Woman with Polycystic Kidney Disease Comes to the Office