NURS 6501 Week 2 Case Study Analysis

Case Study Analysis

End-stage renal disease is a chronic condition with increasing global rates. The mainstream treatments mainly include dialysis and kidney transplants. Kidney transplants are highly effective and restore patient’s quality of life. However, it predisposes patients to unwanted outcomes should they experience a kidney rejection. Therefore, this essay examines a case study of a 34-year-old Hispanic-American male patient that has experienced acute kidney rejection.

Why the Patient Presented the Described Symptoms

The patient in the case study was well until after six months of the transplant when he started experience a range of symptoms. They include weight gain, decreased urine output, fatigue, and fever. These symptoms led to his diagnosis with acute kidney transplant rejection. The patient developed weight gain because of increased body fluid volume level. Accordingly, the kidneys are largely involved in the excretion of excessive body fluids (Hassanein & Augustine, 2022). The acute rejection impaired with the normal fluid balance regulation by the kidneys, leading too much fluids in the body, hence, weight gain.

The patient also developed decreased urinary output. The decrease is attributable to a reduced kidney functioning rate. The kidneys do not excrete the excessive body fluids volume, leading to decreased urinary output. Besides excreting excess fluids, kidneys also facilitate the excretion of toxins such as ammonia and urea from the body. Impaired renal function lead to the accumulation of these toxins in the body. Patients experience symptoms such as difficulty in concentration and fatigue. In addition, severe kidney damage causes anemia, which is associated with symptoms such as fatigue (Carminatti et al., 2019). Kidney injury also lowers the patient’s immunity. This predisposes him to sepsis, as evidenced by fever.

Genes Associated with the Development of the Disease

Genes play a crucial role in the development of kidney transplant rejection. One of the genes is the human cytokine synthesis inhibitor or interleukin 10 (IL-10). IL-10 is a gene that a gene involved in the inhibition of inflammatory processes following organ donation. However, it can also inhibit the maturation of antigen cells that are crucial for preventing inflammatory processes in organ rejection. Gene disparities between the donor and receiver also contributed to the development of the acute kidney rejection. Often, the receiver’s genes and antibodies perceive the new kidney foreign, leading to attempts to eliminate it causing rejection. The genes that mediate this process include class I and II HLA genes. The other gene is IL-10 polymorphism. IL-10 polymorphism causes organ rejection by inhibiting the release of IL-10, which heightens immune system’s damage of the donated organ (Reindl-Schwaighofer et al., 2019; Yazdani et al., 2019). Combined, these genes elevate the individual’s risk of developing kidney transplant rejection.

The Process of Immunosuppression and Effect on Body Systems

Immunosuppression is a situation where the body’s ability to fight against infections and disease causing microorganisms is reduced. The causes of immunosuppression are varied. They include chronic conditions such as cancer and end-stage renal disease, medications, nutritional deficiencies, and exposure to harmful radiations. These causes depress the ability of the bone marrow to produce white blood cells, hence, vulnerability to diseases. One of the effects of immunosuppression on the body is increased vulnerability to infections and recurrent infections. Severe cases may result in mortalities (Salminen, 2020; Tang et al., 2020).

In summary, the patient in the case study developed symptoms due to kidney failure and immunosuppression. Genes play a role in kidney transplant rejection. Immunosuppression lowers the body response mechanisms to infections and increases the risk of mortalities in severe cases. Interventions to minimize the risk of immunosuppression in hospitalized patients should be explored.

References

Carminatti, M., Tedesco-Silva, H., Silva Fernandes, N. M., & Sanders-Pinheiro, H. (2019). Chronic kidney disease progression in kidney transplant recipients: A focus on traditional risk factors. Nephrology, 24(2), 141–147. https://doi.org/10.1111/nep.13483

Hassanein, M., & Augustine, J. J. (2022). Chronic Kidney Transplant Rejection. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK549762/

Reindl-Schwaighofer, R., Heinzel, A., Kainz, A., van Setten, J., Jelencsics, K., Hu, K., Loza, B.-L., Kammer, M., Heinze, G., Hruba, P., Koňaříková, A., Viklicky, O., Boehmig, G. A., Eskandary, F., Fischer, G., Claas, F., Tan, J. C., Albert, T. J., Patel, J., … Oberbauer, R. (2019). Contribution of non-HLA incompatibility between donor and recipient to kidney allograft survival: Genome-wide analysis in a prospective cohort. The Lancet, 393(10174), 910–917. https://doi.org/10.1016/S0140-6736(18)32473-5

Salminen, A. (2020). Activation of immunosuppressive network in the aging process. Ageing Research Reviews, 57, 100998. https://doi.org/10.1016/j.arr.2019.100998

Tang, F., Tie, Y., Tu, C., & Wei, X. (2020). Surgical trauma-induced immunosuppression in cancer: Recent advances and the potential therapies. Clinical and Translational Medicine, 10(1), 199–223. https://doi.org/10.1002/ctm2.24

Yazdani, S., Callemeyn, J., Gazut, S., Lerut, E., de Loor, H., Wevers, M., Heylen, L., Saison, C., Koenig, A., Thaunat, O., Thorrez, L., Kuypers, D., Sprangers, B., Noël, L.-H., Van Lommel, L., Schuit, F., Essig, M., Gwinner, W., Anglicheau, D., … Naesens, M. (2019). Natural killer cell infiltration is discriminative for antibody-mediated rejection and predicts outcome after kidney transplantation. Kidney International, 95(1), 188–198. https://doi.org/10.1016/j.kint.2018.08.027

ORDER A PLAGIARISM-FREE PAPER HERE

Case Study Analysis

An understanding of cells and cell behavior is a critically important component of disease diagnosis and treatment. But some diseases can be complex in nature, with a variety of factors and circumstances impacting their emergence and severity.

Effective disease analysis often requires an understanding that goes beyond isolated cell behavior. Genes, the environments in which cell processes operate, the impact of patient characteristics, and racial and ethnic variables all can have an important impact.

An understanding of the signals and symptoms of alterations in cellular processes is a critical step in the diagnosis and treatment of many diseases. For APRNs, this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify cell, gene, and/or process elements that may be factors in the diagnosis, and you explain the implications to patient health.

Resources

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES

To prepare:

By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Announcements” section of the classroom for your assignment from your Instructor.

For week two, here is the case study analysis scenario. Please note that this is due by day seven of week two:

A 34-year-old Hispanic-American male with end-stage renal disease received kidney transplant from a cadaver donor, as no one in his family was a good match. His post-operative course was uneventful, and he was discharged with the antirejection drugs Tacrolimus (Prograf), Cyclosporine (Neoral), and Imuran (Azathioprine). He did well for 3 months and had returned to his job as a policeman. Six months after his transplant, he began to gain weight, had decreased urine output, was very fatigued, and began to run temperatures up to 101ËšF. He was evaluated by his nephrologist, who diagnosed acute kidney transplant rejection.

Blessings,

Dr. F

The Assignment

Develop a 1- to 2-page case study analysis in which you:

• Explain why you think the patient presented the symptoms described.
• Identify the genes that may be associated with the development of the disease.
• Explain the process of immunosuppression and the effect it has on body systems.

By Day 7 of Week 2

Submit your Case Study Analysis Assignment by Day 7 of Week 2.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates

Links to an external site.). All papers submitted must use this formatting.

submission information

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

1. To submit your completed assignment, save your Assignment as MD1Assgn_LastName_Firstinitial
2. Then, click on Start Assignment near the top of the page.
3. Next, click on Upload File and select Submit Assignment for review.

Rubric

NURS_6501_Module1_Case Study_Assignment_Rubric