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week11eplies.docxAnemia of chronic kidney disease
Elsa Sosa
ANEMIA OF CHRONIC KIDNEY DISEASE
Diagnosis: Anemia Of Ckd:
1. List specific goals of treatment for M.W.
Iron deficiency is frequent in patients with chronic kidney disease. However, The leading
cause of anemia of chronic kidney disease is erythropoietin's inadequate production (cases et
al.,2018). M.W diagnosis indicates anemia of CKD. For this reason, the specific goals of
treatment are correction of iron deficiencies and restoring adequate production of
erythropoietin.
2. What drug therapy would you prescribed? Why?
For this patient, intravenous iron is the therapy I would prescribe. M.W has other underlying
conditions such as hypertension. Besides, Iron deficiency is the most common cause of
hyporesponsiveness to ESAs (Hazin,2020). Therefore erythropoiesis-stimulating
agents(ESAs) should be used cautiously in this patient.
3. What are the parameters for monitoring success of therapy?
The monitoring success parameters include; ferritin, transferrin saturation, hypochromic
red blood cell percentage, reticulate hemoglobin content, and increased erythropoietic
response(Hazin,2020).
4. Discuss specific patient education based on the prescribed therapy.
The physician should educate the patient on the safety and the risks associated with the
intravenous iron therapy addition. The patient should be educated on the advantages of
selecting an intravenous therapy over oral therapy.
5. List one or two adverse reactions for the selected agent that would cause you to change
treatment.
The possible risks associated with IV iron therapy include; anaphylaxis and endothelial
dysfunction.
6. What over-the-counter and/or alternative medications would be appropriate for M.W.?
Oral haematinics are the best alternate over-the-counter medications for M.W.Although
the oral iron supplements are slow in rectifying the hemoglobin levels; most patients will
tolerate them (Cases et al.,2018).
7. What dietary and lifestyle changes would you recommend for M.W.?
Lifestyle and dietary changes would also help M.W manage the anemia and control
chronic kidney disease symptoms. M.K should always take a diet rich in fruits and
vegetables. She should avoid fatty meals but instead use whole grains, fish, poultry,
beans, seeds, and nuts. The diet is known as the DASH diet and aims at controlling
related diseases such as hypertension, heart diseases, and kidney disease. Lifestyle
changes should include regular exercise, smoke reduction, and reduced sodium intake
(National Kidney Foundation, 2017).
References
Cases, A., Egocheaga, M., Tranche, S., Pallarés, V., Ojeda, R., Górriz, J., & Portolés, J. (2018).
Anemia of chronic kidney disease: Protocol of study, management and referral to
Nephrology. Nefrología (English Edition), 38(1), 8-12. doi: 10.1016/j.nefroe.2018.01.007
Hazin, M. A. A. (2020). Anemia in chronic kidney disease. Revista da Associação Médica
Brasileira, 66( 1), 55-58. Epub January 13, 2020. https://doi.org/10.1590/1806-
9282.66.s1.55
National Kidney Foundation(2017).The Dash Diet.Retrieved from
https://www.kidney.org/atoz/content/Dash_Diet
Jenny Tase Corria
M.W, an African American male aged 69 years, was referred for further medical evaluation. The patient had other underlying medical complications like hypertension, type 2 diabetes, deep vein thrombosis, among other conditions. The examination also ascertained that he used alcohol and smoked as well. His BMI falls under the category of overweight. Therefore, this paper discusses specific treatment goals and dietary and lifestyle changes that a healthcare provider would recommend for the patient.
Specific Goals of Treatment
After diagnosis, M.W was found to have Anemia of CKD. The anemia chronic kidney disease is a condition characterized by damaged kidneys, which end up not being able to filter blood appropriately; as a result, wastes and fluids end up building in the patient’s body (NIH, 2021). The specific goal of treatment is to treat the patients underlying condition that is causing the anemia. Hence the patient will be required to take treatments addressing deficiency of vitamins and iron. The patient should then be referred to a hematologist to treat the kidney condition.
The patient will require drug therapy. The specific drug therapy would be prescribing an erythropoiesis-stimulating agent (ESA) to help address anemia since ESA stimulates the bone marrow to create extra red blood cells. The parameters for monitoring drug therapy's success would be based on the ease of the symptoms related to Anemia CKD. If the patient reports better ease of the underlying symptoms, that would be a positive signal about drug therapy's functionality. The prescribed drug is expected to help stimulate the bone marrow to produce extra blood cells. Based on the prescribed drug therapy, patient education is important in getting the desired results. In this case, M.W should be taught to be observant with foods to eat to help the drugs function better. Part of the education includes improving on foods high in vitamins and iron.
Even though the drugs are meant to help ease the patient’s symptoms, there are situations when the drug therapy needs to be reconsidered. If the erythropoiesis-stimulating agent (ESA) therapy shows adverse side effects, it would have to be changed. One of the conditions is when M.W shows worsening blood pressure conditions. Especially because he has underlying high blood pressure conditions (Drüeke, 2018), another adverse effect that would result in changing the medication is when the patient reports fever incidences as that is one of the side effects of erythropoiesis-stimulating agent (ESA). An over-the-counter drug that would help the patient in treating Anemia of CKD includes folate supplements, as they help the patients recommence normal production of red blood cells. Also high doses of vitamin C 2 g per day, can help the iron absorption.
In addition to medication, the patient is also required to adhere to dietary and lifestyle changes. Part of the recommendation is that M.W needs to concentrate on the uptake of foods rich in vitamin B12 and iron. The foods will help boost his medication work even better since he will be adhering to a diet that helps recover a patient with Anaemia of CKD. Even though the diet is helpful, it is important to observe the quantity of the food consumed since most of the foods consumed will likely have high contents of protein, phosphorous, and in some instances, sodium (Rysz et al., 2017). He must work closely with a dietician not to consume much of the mentioned nutrients since they are supposed to be taken with limitations. Also, M.W needs to change his lifestyle; he should stay away from drinking alcohol and smoking.
Reference
Drüeke, T.B. (2018). Lessons from clinical trials with erythropoiesis-stimulating agents (ESAs).
Ren Replace Ther 4, 46. https://doi.org/10.1186/s41100-018-0187-2
National Institute of Diabetes and Digestive and Kidney Disease (NIH). (2021). Anemia in Chronic
Rysz, J., Franczyk, B., Ciałkowska-Rysz, A., & Gluba-Brzózka, A. (2017). The Effect of Diet on the Survival
of Patients with Chronic Kidney Disease. Nutrients, 9(5), 495. https://doi.org/10.3390/nu9050495
