NURS 6501: MIDTERM EXAM: Please contact Assignment Samurai for help with NURS 6501: Midterm Exam or any other assignment. Email: assignmentsamurai@gmail.com   Which of the following mechanisms contributes to the progression of chronic kidney disease? Group of answer choices

• Overactivity of the renin-angiotensin-aldosterone system
• Upregulation of parathyroid hormone secretion
• Excessive secretion of antidiuretic hormone
• Inadequate erythropoietin production

  The correct answer is Overactivity of the renin-angiotensin-aldosterone system.   Explanation: In chronic kidney disease (CKD), one of the key mechanisms that contributes to disease progression is the overactivity of the renin-angiotensin-aldosterone system (RAAS). This system is typically activated in response to perceived low blood pressure or decreased blood flow to the kidneys. However, chronic activation of RAAS in CKD leads to harmful effects such as:

• Vasoconstriction, which increases blood pressure and contributes to further kidney damage.
• Increased sodium and water retention (via aldosterone), leading to fluid overload and hypertension.
• Glomerular hypertension and hyperfiltration, which accelerate the progression of kidney damage over time.

Why the other options are incorrect:

• Upregulation of parathyroid hormone secretion: While increased parathyroid hormone (PTH) levels can occur in CKD due to impaired phosphate excretion and calcium imbalance, this is a secondary effect. PTH upregulation leads to secondary hyperparathyroidism, but it is not a primary driver of CKD progression compared to RAAS overactivity.
• Excessive secretion of antidiuretic hormone: Antidiuretic hormone (ADH) promotes water retention and helps maintain fluid balance. Excessive ADH secretion can occur in advanced CKD due to water retention, but it is not a primary driver of disease progression like RAAS overactivity.
• Inadequate erythropoietin production: While inadequate erythropoietin (EPO) production is common in CKD, contributing to anemia, it is a consequence of kidney damage rather than a primary cause of disease progression. The primary drivers of CKD progression are factors like RAAS overactivity, glomerular hypertension, and fibrosis.

Thus, the overactivity of the renin-angiotensin-aldosterone system plays a central role in the progression of chronic kidney disease.