Case Study

Discussion Post: Anaemia of Ckd

Fernando Wong

Florida National University

 

1. List specific goals of treatment for M.W.

The specific goals of treatment for M.W include the following:

1. prevent further anemia complications

2. maintain a haemoglobin >10g/dL (Brodski et al., 2018).

3. What drug therapy would you prescribe? Why?

I would prescribe Epoetin or darbepoetin with a beginning dose if 50 to 100 units/kg administered subcutaneously three times on a weekly basis until the patient achieves a haemoglobin target of 11 to 12 g/dL (Farragher et al., 2020). This drug therapy is effective in the replacement of hormone deficiency in patient with chronic kidney disease that causes anaemia.

1. What are the parameters for monitoring success of therapy?

The parameters for monitoring success of therapy would result from an enquiry into the patient’s quality of life. An improved quality would indicate success of the therapy, otherwise, another second line therapy would be necessary (Brodski et al., 2018).

1. Discuss specific patient education based on the prescribed therapy.

The first patient education would be to discuss with and educate the patient on the possible adverse reactions such as cardiovascular and cerebrovascular events, dizziness, vomiting, seizure, angioedema, headache, fever, hypokalaemia, bronchospasms, cough, infection, myalgia, hypertension, and heart failure (O’Lone et al., 2016). I would also advise the patient not to use Epogen because it does not work well with patient with unregulated blood pressure.

1. List one or two adverse reactions for the selected agent that wouldcause you to change therapy.

Some of the adverse reactions for the selected agent (Epogen) that would cause the need to change therapy are (Farragher et al., 2020):

1. Allergic reactions to medications,or

2. Unregulated hypertension

3. What over-the-counter and/or alternative medications would beappropriate for M.W.?

There are no over-the-counter and/or alternative medications that would be appropriate for M.W.

1. What dietary and lifestyle changes would you recommended for M.W.?

Some of the dietary and lifestyle changes I would recommend for M.W include weight loss, exercise, low-sodium diet, and low-phosphate diet (O’Lone et al., 2016).

 

References

Brodski, J., Rossell, S., Castle, D., & Tan, E. (2018). A Systematic Review of Cognitive Impairments Associated with Kidney Failure in Adults Before Natural Age-Related Changes. Journal of The International Neuropsychological Society, 25(1), 101-114. https://doi.org/10.1017/s1355617718000917

Farragher, J., Stewart, K., Harrison, T., Engel, L., Seaton, S., & Hemmelgarn, B. (2020). Cognitive interventions for adults with chronic kidney disease: protocol for a scoping review. Systematic Reviews, 9(1). https://doi.org/10.1186/s13643-020-01320-x

O’Lone, E., Connors, M., Masson, P., Wu, S., Kelly, P., & Gillespie, D. et al. (2016). Cognition in People with End-Stage Kidney Disease Treated with Hemodialysis: A Systematic Review and Meta-analysis. American Journal of Kidney Diseases, 67(6), 925-935. https://doi.org/10.1053/j.ajkd.2015.12.028