DaVita Dietitian Reference Manual Module 6-Mineral and Bone Disorder Management CASE STUDIES Case 1 James is a 37 year old African American male with CKD Stage 5 secondary to hypertension. He has been on hemodialysis for 5 years. He has a history of hypocalcemia and hyperparathyroidism. He weighs 63 kg. His albumin usually runs in the range of 3.7-3.8 mg/dL. His binder prescription is PhosLo 667 mg, 2 gelcaps at each meal and 1 with snacks. Labs Intact.PTH Corrected Calcium Phos IV Hectorol mcg 7/20 8.1 5.4 1.0 mcg 8/3 8.0 4.6 1.0 mcg 9/28 400 8.5 4.4 1.5 mcg 10/5 8.8 5.0 1.5 mcg 11/16 9.6 5.0 1.5 mcg 12/28 420 9.9 5.4 Per the Zen Tool, what change (if any) would be made to the IV Vitamin D dose? What are your thoughts on the labs? Case 2 Joseph is a 58 year old Hispanic male, on hemodialysis for one year. He has a history of hyperparathyroidism and hyperphosphatemia. He weighs 74 kg. His binder prescription is Fosrenol 500 mg 1 tablet with each meal. Labs Intact PTH Corrected Calcium Phos IV Hectorol mcg 12/29 730 9.5 7.2 0 1/5 715 10.1 6.3 3 2/8 404 8.9 6.5 2 5/5 98 9.5 6.3 What are your thoughts regarding the Intact PTH results? What therapy options would you recommend? What are your thoughts regarding patient education needs? ©2013 DaVita HealthCare Partners Inc. All rights reserved. Copyrighted Material Page 27 of 44 Origination Date: April 2001
DaVita Dietitian Reference Manual Module 6-Mineral and Bone Disorder Management CASE STUDIES Case 1 James is a 37 year old African American male with CKD Stage 5 secondary to hypertension. He has been on hemodialysis for 5 years. He has a history of hypocalcemia and hyperparathyroidism. He weighs 63 kg. His albumin usually runs in the range of 3.7-3.8 mg/dL. His binder prescription is PhosLo 667 mg, 2 gelcaps at each meal and 1 with snacks. Labs Intact.PTH Corrected Calcium Phos IV Hectorol mcg 7/20 8.1 5.4 1.0 mcg 8/3 8.0 4.6 1.0 mcg 9/28 400 8.5 4.4 1.5 mcg 10/5 8.8 5.0 1.5 mcg 11/16 9.6 5.0 1.5 mcg 12/28 420 9.9 5.4 Per the Zen Tool, what change (if any) would be made to the IV Vitamin D dose? What are your thoughts on the labs? Case 2 Joseph is a 58 year old Hispanic male, on hemodialysis for one year. He has a history of hyperparathyroidism and hyperphosphatemia. He weighs 74 kg. His binder prescription is Fosrenol 500 mg 1 tablet with each meal. Labs Intact PTH Corrected Calcium Phos IV Hectorol mcg 12/29 730 9.5 7.2 0 1/5 715 10.1 6.3 3 2/8 404 8.9 6.5 2 5/5 98 9.5 6.3 What are your thoughts regarding the Intact PTH results? What therapy options would you recommend? What are your thoughts regarding patient education needs? ©2013 DaVita HealthCare Partners Inc. All rights reserved. Copyrighted Material Page 27 of 44 Origination Date: April 2001
Comprehensive Medical Assisting: Administrative and Clinical Competencies (MindTap Course List)
6th Edition
ISBN:9781305964792
Author:Wilburta Q. Lindh, Carol D. Tamparo, Barbara M. Dahl, Julie Morris, Cindy Correa
Publisher:Wilburta Q. Lindh, Carol D. Tamparo, Barbara M. Dahl, Julie Morris, Cindy Correa
Chapter33: Nutrition In Health And Disease
Section: Chapter Questions
Problem 33.3CS
Related questions
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Transcribed Image Text:DaVita Dietitian Reference Manual
Module 6-Mineral and Bone Disorder Management
CASE STUDIES
Case 1
James is a 37 year old African American male with CKD Stage 5 secondary to
hypertension. He has been on hemodialysis for 5 years. He has a history of
hypocalcemia and hyperparathyroidism. He weighs 63 kg. His albumin usually runs in
the range of 3.7-3.8 mg/dL. His binder prescription is PhosLo 667 mg, 2 gelcaps at
each meal and 1 with snacks.
Labs
Intact.PTH
Corrected
Calcium
Phos
IV Hectorol
mcg
7/20
8.1
5.4
1.0 mcg
8/3
8.0
4.6
1.0 mcg
9/28
400
8.5
4.4
1.5 mcg
10/5
8.8
5.0
1.5 mcg
11/16
9.6
5.0
1.5 mcg
12/28
420
9.9
5.4
Per the Zen Tool, what change (if any) would be made to the IV Vitamin D dose?
What are your thoughts on the labs?
Case 2
Joseph is a 58 year old Hispanic male, on hemodialysis for one year. He has a history
of hyperparathyroidism and hyperphosphatemia. He weighs 74 kg. His binder
prescription is Fosrenol 500 mg 1 tablet with each meal.
Labs
Intact PTH
Corrected
Calcium
Phos
IV Hectorol
mcg
12/29
730
9.5
7.2
0
1/5
715
10.1
6.3
3
2/8
404
8.9
6.5
2
5/5
98
9.5
6.3
What are your thoughts regarding the Intact PTH results?
What therapy options would you recommend?
What are your thoughts regarding patient education needs?
©2013 DaVita HealthCare Partners Inc. All rights reserved.
Copyrighted Material
Page 27 of 44
Origination Date: April 2001
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