NURS 6501 Scenario 3: A 34-year-old Male with Acute Kidney Transplant Rejection Essay

NURS 6501 Scenario 3: A 34-year-old Male with Acute Kidney Transplant Rejection Essay

Case Study

Kidney transplant is one of the effective treatments for patients diagnosed with end-stage renal disease. However, some patients develop complications such as kidney rejection, lowering treatment outcomes and patient’s quality of life. Therefore, this essay examines a case study involving a patient that experienced an acute kidney rejection. The essay focuses on topics that include the reasons for the presented symptoms, genes associated with it, and process of immunosuppression.

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Why the Patient Presented the Described Symptoms

The patient presented with weight gain. The weight gain is attributed to excessive body fluids due to reduced renal elimination of fluids. Kidneys excrete excess water from the body, a process impaired with the kidney rejection. The patient also presented with decreased urinary output. The decrease is because of reduced renal functions, including glomerular filtration of fluids. This results in oliguria. The patient was also fatigued. The excessive body fluids result in fluid buildup in the lungs and other body tissues (Naik & Shawar, 2023). The resulting effects include weight gain and fatigue being experienced by the patient.

In addition, the patient is likely to be suffering from anemia. Acute kidney transplant rejection affects the production of erythropoietin by the kidneys. As a result, the patient is likely to develop anemia and its accompanying symptoms such as fatigue. The patient also presented with elevated body temperature. The elevation is attributed to the accumulation of toxins such as urea and ammonia with the reduced renal function. The patient is also immunosuppressed, which predisposes him to infections(Naik & Shawar, 2023). Therefore, the likelihood of an infection or accumulation of toxins in the body contributes to the elevated temperature.

Genes Associated with the Development of the Disease

Genes play a role in the development of acute kidney rejection. Studies have shown that polymorphism in some genes increase the risk of patients developing acute kidney rejection. The genes include FOXP3, CYP3A, VEGF, and TGF beta. These genes cause inflammatory processes in patients who have undergone kidney transplant, leading to rejection. Evidence has also linked Protein Tyrosine Phosphatase Receptor Type O (PTPRO) and CCDC667 genes with T-cell mediated acute rejection (Eikmans et al., 2019). Other studies have also shown that SNPD rs2910164 cause T-cell mediated and antibody-mediated acute rejection some patients. LIMS1 genes also contribute to antibody-mediated acute rejection in some patients. Other biomarkers contribute to acute kidney rejection. They include kidney injury molecule-1, C-X.X Motif chemokine 10, and osteopontin (Salvadori, 2023).

Process of Immunosuppression

Immunosuppression refers to a state in which the body’s defense mechanisms are depressed. There is the lowering of the body’s mechanism to fight against infectious agents. Immunosuppression develops from the destruction of immune effector cells or blocks the intracellular pathways needed for antigen recognition in the immune response. Immunosuppression arises from causes such as chronic conditions that include cancer and HIV/AIDs among others. It also develops from the use of medications and exposure to ionizing radiations (Rice, 2019). The effect of immunosuppression on the body include predisposing patients to infections, delayed recovery from infections, prolonged hospitalization, increased care costs, and mortality.

Conclusion

The patient presented the described symptoms in the case study because of the decrease in renal functioning. Several genes contribute to the development of acute kidney rejection in patients that undergo kidney transplant. Immunosuppression affects the body’s ability to fight against infectious agents. Immunosuppression predisposes patients to infections, prolonged hospitalization, increased care costs, and risk of premature mortalities.

References

Eikmans, M., Gielis, E. M., Ledeganck, K. J., Yang, J., Abramowicz, D., & Claas, F. F. J. (2019). Non-invasive Biomarkers of Acute Rejection in Kidney Transplantation: Novel Targets and Strategies. Frontiers in Medicine, 5. https://www.frontiersin.org/articles/10.3389/fmed.2018.00358

Naik, R. H., & Shawar, S. H. (2023). Renal Transplantation Rejection. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK553074/

Rice, J. M. (2019). Immunosuppression. In R. A. Baan, B. W. Stewart, & K. Straif (Eds.), Tumour Site Concordance and Mechanisms of Carcinogenesis. International Agency for Research on Cancer. http://www.ncbi.nlm.nih.gov/books/NBK570319/

Salvadori, M. (2023). Role of Biomarkers in Detecting Acute Rejection in Kidney Transplantation. Transplantology, 4(1), Article 1. https://doi.org/10.3390/transplantology4010004

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You will review the listed case study below and present your findings in a 1–2-page case study analysis.

Case Study:

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.

The Assignment (1- to 2-page case study analysis)

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.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. APA formatting.

Be sure that your paper is no one than 1-2 content pages. You are to also include both a title page and a reference page. No more than 1-2 content pages.
This assignment requires at least 4 to 5 primary sources
The course Case Study Assignments will require that you completely and accurately demonstrate critical thinking via assimilation and synthesis of ideas when using credible outside and course-specific resources (i.e., video, required readings, textbook); comparing different points of view; highlighting similarities, differences, and connections; and/or when lending support to your Assignment responses.