1.
What are the criteria to be placed in the transplant list?
The patient must not have any chronic medical conditions that make the procedure high risk. Patients that are high risk are not good candidates for the procedures.
What options for transplantation does Mr. Rojas have?
Mr. Rojas has chronic preexisting health issues such as hypertension, type 1 diabetes that is uncontrolled. That alone some would say it would be a big risk to give him a transplant.
What recommendations can you give Mr. Rojas on treatment compliance?
I would recommend that he see a nutritionist to help him with his food choices and sodium intake, I would recommend him closely monitor his glucose and teach compliance on taking his blood pressure medications.
What other renal replacement therapies could Mr. Rojas be educated about?
Hemodialysis, the most complex form of therapy it can be done in center as well as at home and peritoneal dialysis and it can be a great benefit to him.
What are their advantages and disadvantages?
Advantages of in-center hemodialysis is the work is done for you. The disadvantage is that you have to come to treatment 3 days a week for 3-4 hours. It’s almost like a part time job it takes time from your daily life and you may not like the hours or days you’re given.
2.
- What are the criteria to be placed in the transplant list?
The basic criteria for kidney transplant selection include the presence of irreversible kidney failure. Any adult or child that has been diagnosed with stage 5 CKD or end-stage renal disease can be considered for transplant evaluation. In addition to using kidney transplant criteria to determine eligibility for a transplant, there are contraindications that can preclude a patient from being considered for transplant. Contraindications include: active malignancy, active abuse of drugs, severe cardiac and/or peripheral vascular disease, body mass index higher than 40.
- What options for transplantation does Mr. Rojas have?
Deceased donor kidney transplant( is an individual who has recently passed away of causes not affecting the organ intended for transplant) Standard Criteria Donor( These kidney are from donors under age 50 and do not meet any of the criteria that are assigned to expanded criteria donors).
- What recommendations can you give Mr. Rojas on treatment compliance?
Recommendations for immunosuppression, graft monitoring, as well as prevention and treatment of infection, cardiovascular disease, malignancy, and other complications that are common in kidney transplant recipients, including hematological and bone disorders.
- What other renal replacement therapies could Mr. Rojas be educated about?
Peritoneal Dialysis( uses the peritoneum as a natural semi-permeable membrane for diffusive removal of solutes). Intermittent hemodialysis( process of solute clearance based on diffusion across the membrane driven by a concentration gradient between the blood and dialysate). Continuous renal replacement therapies( any renal replacement therapy that is intended to be applied for 24 hours per day in the ICU.
- What are their advantages and disadvantages?
Advantages:
- facilitate fluid and solute homeostasis.
- useful for hemodynamically unstable patients.
- control of acid base status.
- ability to provide protein-rich nutrition while achieving uremic control.
Disadvantages:
- it usually requires more intensive anticoagulation
- patients are at risk for bleeding and electrolyte disturbance
- patients must remain immobile for long periods of time to ensure proper machine function.
