Acute Kidney Transplant Rejection (AKTR) immunosuppression Essay- NURS 6501 Module 1 Assignment: Case Study Analysis
Introduction
The kidneys are vital organs in humans. They help filter and excrete waste products from the body, remove excess fluid from the body and helps the body maintain homeostasis by regulating acid-base balance as well as fluid and electrolytes (National Institute of Diabetes and Digestive and Kidney Diseases, 2018). Loss of kidney function can alter many essential functions in the body, as seen in patients with kidney failure. End-stage renal disease (ESRD) is the final stage of Chronic Kidney Disease (CKD), resulting in kidneys that cannot independently perform its functions. Many conditions can lead to chronic kidney disease development, some of which include heart disease, hypertension, inflammation, diabetes, and hereditary traits, or some genetic disorders (John Hopkins Medicine, 2018). The treatment options for ESRD are dialysis or a kidney transplant. The purpose of this paper is to analyze a case study of a 34-year-old man diagnosed with Acute Kidney Transplant Rejection (AKTR), to understand the symptoms he presented, and the genes associated with his diagnosis. The paper would also include an analysis of the process of immunosuppression and its effect on body systems.Acute Kidney Transplant Rejection (AKTR) immunosuppression Essay- NURS 6501 Module 1 Assignment: Case Study Analysis. Acute Kidney Transplant Rejection (AKTR) immunosuppression Essay- NURS 6501 Module 1 Assignment: Case Study Analysis.
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Analysis of Diagnosis and its Symptoms
The treatment options for ESRD are dialysis and kidney transplants, and both have benefits and risks associated with them. Kidney transplant as a treatment choice for ESRD may be more appealing to some individuals as opposed to committing to a lifetime of dialysis. However, kidney transplants may have some serious complications, such as AKTR. AKTR is an immune response in which the body attacks the new kidneys like it was a pathogen or foreign substance causing damage or failure of the new kidney. Before a kidney transplant is done, both donor and recipient undergo a series of compatibility tests to prevent a hyperacute rejection, which may happen minutes after surgery (Naik, & Shawar, 2020). However, kidney rejection could still occur at any time, although the chances decrease with time, an AKTR can occur between days to months following surgery for various reasons.
In this scenario, the individual exhibited weight gain, decreased urine output, fatigue, and
fever; these are typical symptoms of AKTR which the subject experienced about six months after receiving a kidney transplant from a cadaver donor. According to Naik and Shawar (2020), there is an increased chance of rejection when receiving a kidney transplant from a cadaver donor. The authors also indicated other causes such as younger recipients, history of rejection, and inadequate immunosuppression, among others, might increase the chances of rejection post-transplant. Other symptoms of AKTR includes pain and tenderness around the kidney, flu-like symptoms including chills, headaches, elevated serum creatinine levels and nausea and vomiting (National Institute of Medicine, 2019). Another possible reason why the patient experienced symptoms of acute kidney transplant rejection is non-adherence and antibody-mediated rejection (Hucker et al.,2017).Acute Kidney Transplant Rejection (AKTR) immunosuppression Essay- NURS 6501 Module 1 Assignment: Case Study Analysis.
Gene Associated with the Condition
ESRD is the last phase of chronic disease. It is often caused by underlying conditions that may be inherited, such as diabetes and hypertension, which are the two leading causes of chronic kidney disease (Centers for Disease Control and Prevention, 2019). Some genetic diseases can
also directly or indirectly lead to Chronic kidney disease and, subsequently, ESRD, for example, conditions like nephronophthisis, autosomal dominant polycystic kidney disease (ADPKD), lowe syndrome, amongst others (The University of Michigan, n.d.). ADPKD occurs as a result of an
inherited abnormal mutation in polycystin, a kidney protein causing kidney problems that could lead to kidney failure even at birth (UNC kidney Center, 2019). a study by Canadas-Garre et al. (2019), indicated a link between shorter telomere and renal dysfunction or the progression of CKD. Abnormalities such as shorter telomer at birth are inherited due to abnormal genetic mutation of DNA predisposes individuals to certain disease conditions, for example, cardiovascular disease. Kidney transplant and how an individual’s body reacts to the new kidneys can be dependent on some genetic traits, for example, Human Leukocyte Antigen (HLA) compatibility between donor and recipient is more favorable with kidney transplant, decreasing the chances for AKTR (Dorr, Oetting, Jacobson, & Israni, 2018). The authors also indicated that high metabolic rates of immunosuppressants in the blood have been linked to an increased risk of having acute rejection.
Immunosuppression and its Effect on the Body
Immunosuppression is a term used to describe the suppression of the body’s immune system and its ability to defend the body against infection (National Cancer Institute, n.d.). Immunosuppression may be due to several disease conditions, genetics, or even medications such as steroids, immunosuppressants, and cancer medications. Immunosuppression therapy
is commonly used to decrease the immune response after organ transplantation to prevent transplant rejection; it can also be used in other conditions such as autoimmune disorders such as rheumatoid arthritis. The immune system is programmed to identify and attack pathogens and foreign bodies that gain entrance to the body (McCance & Huether, 2019). Immunosuppressants work by either inhibiting calcineurin, thereby preventing T cells from activating cytokines or by inhibiting the proliferation of T cells, thereby suppressing the immune response.
Immunosuppression related to genetics or medications generally affects the body by decreasing its immune functions and making it more susceptible to infections and cancer. However, immunosuppression also affects other systems in the body, for example, cardiovascular, respiratory, musculoskeletal, genitourinary, and central nervous systems. They affect the cardiovascular system by causing hypertension and altering the normal functions of blood vessels, which may lead to other cardiovascular diseases, affects the musculoskeletal system causing osteoporosis. It also affects the respiratory system leaving the individual susceptible to many respiratory infections, including tuberculosis (Hucker et al.,2017). Immunosuppression also affects the metabolic functions of the body, causing weight gain, and new-onset diabetes mellitus type 1 or worsening of already present diabetes (Hucker et al.,2017).
Conclusion
Genetics is a crucial aspect of medicine; over time, the study of genetics has been improved, helping clinicians have a better understanding of diagnosis and treatment of disease conditions. Kidney transplants’ success depends on the prevention of AKTR and kidney failure, among other complications. Transplant patients should be monitored closely to assess the effectiveness of immunosuppression therapy, adjust them as needed, and quickly identify symptoms indicating rejection for early intervention. Acute Kidney Transplant Rejection (AKTR) immunosuppression Essay- NURS 6501 Module 1 Assignment: Case Study Analysis. Acute Kidney Transplant Rejection (AKTR) immunosuppression Essay- NURS 6501 Module 1 Assignment: Case Study Analysis
References
Canadas-Garre, M., Anderson, K., Cappa, R., Skelly, R., Smyth, L. J., Mcknight, A. J., & Maxwell, A. P. (2019). Genetic Susceptibility to Chronic Kidney Disease – Some More Pieces for the Heritability Puzzle. Retrieved from https://www.frontiersin.org/articles/10.3389/fgene.2019.00453/full
Centers for Disease Control and Prevention. (2019). Chronic kidney disease initiative. Retrieved from https://www.cdc.gov/kidneydisease/publications-resources/2019-national-facts.html
Dorr, C. R., Oetting, W. S., Jacobson, P. A., & Israni, A. K. (2018). Genetics of acute rejection after kidney transplantation. Transplant international: official journal of the European Society for Organ Transplantation, 31(3), 263–277. https://doi.org/10.1111/tri.13084
Hucker, A., Frances, B. Carpenter, L., Lawrence C., Farrington, K., & Sharma, S. (2017). Non-adherence to immunosuppressants following renal transplantation: a protocol for a systematic review. BMJ Open 7(9). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5640118/
John Hopkins Medicine (2018). End-stage Renal Disease (ESRD). Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/end-stage-renal-failure
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
Naik, R. & Shawar, S. H. (2020). Renal transplant rejection. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK553074/
National Cancer Institute. (n.d.). NCI Dictionary of Cancer Terms. Retrieved from https://www.cancer.gov/publications/dictionaries/cancer-terms/def/immunosuppression
National Institute of Diabetes and Digestive and Kidney Diseases (2018). Your kidneys and how they work. U.S. Department of Health and Human Services. Retrieved from
https://www.niddk.nih.gov/health-information/kidney-disease/kidneys-how-they-work
National Institute of Medicine. (2019). Transplant rejection. U.S. National Library of Medicine. Retrieved from https://medlineplus.gov/ency/article/000815.htm
The University of Michigan (n.d.). Inherited kidney conditions. Retrieved from https://www.uofmhealth.org/conditions-treatments/kidney/inherited-kidney-conditions
UNC Kidney center, (2019). Genetics and kidney disease. Retrieved from https://unckidneycenter.org/kidneyhealthlibrary/genetics-kidney-disease-1/
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.
Photo Credit: Getty Images/Hero Images
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. Acute Kidney Transplant Rejection (AKTR) immunosuppression Essay- NURS 6501 Module 1 Assignment: Case Study Analysis.
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 “Course Announcements” section of the classroom for your assignment from your Instructor.
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.
- Acute Kidney Transplant Rejection (AKTR) immunosuppression Essay- NURS 6501 Module 1 Assignment: Case Study Analysis
- 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). All papers submitted must use this formatting.
| Excellent | Good | Fair | Poor | |
|---|---|---|---|---|
| Develop a 1- to 2-page case study analysis, examining the patient symptoms presented in the case study. Be sure to address the following:
Explain why you think the patient presented the symptoms described. |
28 (28%) – 30 (30%)
The response accurately and thoroughly describes the patient symptoms. The response includes accurate, clear, and detailed reasons, with explanation for the symptoms supported by evidence and/or research, as appropriate, to support the explanation. |
25 (25%) – 27 (27%)
The response describes the patient symptoms. The response includes accurate reasons, with explanation for the symptoms supported by evidence and/or research, as appropriate, to support the explanation. |
23 (23%) – 24 (24%)
The response describes the patient symptoms in a manner that is vague or inaccurate. Acute Kidney Transplant Rejection (AKTR) immunosuppression Essay- NURS 6501 Module 1 Assignment: Case Study Analysis The response includes reasons for the symptoms, with explanations that are vague or based on inappropriate evidence/research. |
0 (0%) – 22 (22%)
The response describes the patient symptoms in a manner that is vague and inaccurate, or the description is missing. The response does not include reasons for the symptoms, or the explanations are vague or based on inappropriate or no evidence/research. |
| Identify the genes that may be associated with the development of the disease. |
23 (23%) – 25 (25%)
The response includes an accurate, complete, detailed, and specific analysis of the genes that may be associated with the development of the disease.
|
20 (20%) – 22 (22%)
The response includes an accurate analysis of the genes that may be associated with the development of the disease.
|
18 (18%) – 19 (19%)
The response includes a vague or inaccurate analysis of the genes that may be associated with the development of the disease.
|
0 (0%) – 17 (17%)
The response includes a vague or inaccurate analysis of the genes that may be associated with the development of the disease is missing.
|
| Explain the process of immunosuppression and the effect it has on body systems. |
28 (28%) – 30 (30%)
The response includes an accurate, complete, detailed, and specific explanation of the process of immunosuppression and the effect it has on body systems.
|
25 (25%) – 27 (27%)
The response includes an accurate explanation of the process of immunosuppression and the effect it has on body systems.
|
23 (23%) – 24 (24%)
The response includes a vague or inaccurate explanation of the process of immunosuppression and the effect it has on body systems.
|
0 (0%) – 17 (17%)
The response includes a vague or inaccurate explanation of the process of immunosuppression and the effect it has on body systems.
|
| Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria. |
5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. |
4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive. |
3 (3%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic. |
0 (0%) – 2 (2%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided. |
| Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation |
5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.
|
4 (4%) – 4 (4%)
Contains a few (1 or 2) grammar, spelling, and punctuation errors.
|
3 (3%) – 3 (3%)
Contains several (3 or 4) grammar, spelling, and punctuation errors. Acute Kidney Transplant Rejection (AKTR) immunosuppression Essay- NURS 6501 Module 1 Assignment: Case Study Analysis
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0 (0%) – 2 (2%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
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| Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list. |
5 (5%) – 5 (5%)
Uses correct APA format with no errors.
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4 (4%) – 4 (4%)
Contains a few (1 or 2) APA format errors.
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3 (3%) – 3 (3%)
Contains several (3 or 4) APA format errors.
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0 (0%) – 2 (2%)
Contains many (≥ 5) APA format errors.
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| Total Points: 100 |
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Acute Kidney Transplant Rejection (AKTR) immunosuppression Essay- NURS 6501 Module 1 Assignment: Case Study Analysis