1. Discuss how Robert’s lifestyle choices have contributed to the development and . progression of chronic kidney disease.

From the case study, it is evident that Robert’s lifestyle choices have contributed to the development and progression of chronic kidney disease. Robert drinks heavily and consumes at least 6 cans of beer each night despite of his hypertensive and diabetic condition. Kidneys filter toxic substances from the blood. One of such substances is alcohol that can give rise to changes in kidneys function and make the kidneys less capable from filtering the blood. In addition to it, kidneys maintain the correct amount of water within the system. However, alcohol affects the kidneys in maintaining adequate amount of water within the system. Alcohol dehydrates the entire system and such drying affect the normal functioning of the organs and cells that also include the kidneys. Excessive alcohol consumption elevated Robert’s blood pressure. Alcohol may dilate the blood vessels due to the presence of various chemical triggers like serotonin, histamine, and the heart has to work harder to push blood throughout the system that in turn raise pressure (Koning et al., 2015). While Robert has a medical history of blood pressure and diabetes, he should have include a healthy diet but he has not controlled his alcohol consumption, not even managed to have a good diet. Also, it is evident from the case study that his medication dosage for both conditions has increased over that time, which indicates his ignorance towards his medical conditions or medication adherence, which ultimately cause progression of chronic kidney disease.