DaVita Dietitian Reference Manual Module 12--Peritoneal Dialysis CASE STUDIES Case 1 A 38 year old female patient with polycystic kidney disease is here for a clinic visit. She presents with the following labs: albumin 3.5, Hgb 12.1, Corrected Ca 10.8 (3rd time 10.2), Phosphorus 6.9, K 5.4. Her weight is 185 lbs and she is 6'1" tall. She reports a good appetite and weight has been stable. Two months ago, intact PTH was 1972. She has been counseled numerous times on the importance of controlling calcium and phosphorus, however, she loves milk and cheese. She is on Rocaltrol 0.25 mcg/day. She takes Renvela 800 mg as her phosphate binder, using 3 with meals and 2 with snacks, and she is adherent. Her nephrologist has just prescribed Sensipar 30 mg q dinner. What is your care plan for this patient and what nutritional counseling and patient education would you provide? Case 2 A 65 year old man, S/P heart transplant, Hepatitis C and six-month history on hemodialysis is beginning PD. He is 5'7" and 150 lbs. He will be trained on CAPD. however, he plans to use a cycler. His most recent labs: Albumin 2.8. Ca 8.3. Phosphorus 5.9, intact PTH 152, K 3.2, Hgb 11.1, Ferritin 646, TSAT 22%. His biggest challenge is improving nutritional status, which is likely to decline on PD without aggressive nutritional therapy. After one week training, his albumin is down to 2.3. His appetite has declined and his intake is marginal. What are your recommendations for this new PD patient?
DaVita Dietitian Reference Manual Module 12--Peritoneal Dialysis CASE STUDIES Case 1 A 38 year old female patient with polycystic kidney disease is here for a clinic visit. She presents with the following labs: albumin 3.5, Hgb 12.1, Corrected Ca 10.8 (3rd time 10.2), Phosphorus 6.9, K 5.4. Her weight is 185 lbs and she is 6'1" tall. She reports a good appetite and weight has been stable. Two months ago, intact PTH was 1972. She has been counseled numerous times on the importance of controlling calcium and phosphorus, however, she loves milk and cheese. She is on Rocaltrol 0.25 mcg/day. She takes Renvela 800 mg as her phosphate binder, using 3 with meals and 2 with snacks, and she is adherent. Her nephrologist has just prescribed Sensipar 30 mg q dinner. What is your care plan for this patient and what nutritional counseling and patient education would you provide? Case 2 A 65 year old man, S/P heart transplant, Hepatitis C and six-month history on hemodialysis is beginning PD. He is 5'7" and 150 lbs. He will be trained on CAPD. however, he plans to use a cycler. His most recent labs: Albumin 2.8. Ca 8.3. Phosphorus 5.9, intact PTH 152, K 3.2, Hgb 11.1, Ferritin 646, TSAT 22%. His biggest challenge is improving nutritional status, which is likely to decline on PD without aggressive nutritional therapy. After one week training, his albumin is down to 2.3. His appetite has declined and his intake is marginal. What are your recommendations for this new PD patient?
Chapter15: Adult And Pediatric Dosages Based On Body Weight
Section: Chapter Questions
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Transcribed Image Text:DaVita Dietitian Reference Manual
Module 12--Peritoneal Dialysis
CASE STUDIES
Case 1
A 38 year old female patient with polycystic kidney disease is here for a clinic visit. She
presents with the following labs: albumin 3.5, Hgb 12.1, Corrected Ca 10.8 (3rd time
10.2), Phosphorus 6.9, K 5.4. Her weight is 185 lbs and she is 6'1" tall. She reports a
good appetite and weight has been stable. Two months ago, intact PTH was 1972.
She has been counseled numerous times on the importance of controlling calcium and
phosphorus, however, she loves milk and cheese. She is on Rocaltrol 0.25 mcg/day.
She takes Renvela 800 mg as her phosphate binder, using 3 with meals and 2 with
snacks, and she is adherent. Her nephrologist has just prescribed Sensipar 30 mg q
dinner. What is your care plan for this patient and what nutritional counseling and
patient education would you provide?
Case 2
A 65 year old man, S/P heart transplant, Hepatitis C and six-month history on
hemodialysis is beginning PD. He is 5'7" and 150 lbs. He will be trained on CAPD.
however, he plans to use a cycler. His most recent labs: Albumin 2.8. Ca 8.3.
Phosphorus 5.9, intact PTH 152, K 3.2, Hgb 11.1, Ferritin 646, TSAT 22%. His
biggest challenge is improving nutritional status, which is likely to decline on PD without
aggressive nutritional therapy. After one week training, his albumin is down to 2.3. His
appetite has declined and his intake is marginal. What are your recommendations for
this new PD patient?
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