M, a 72 year-old widow with neprohritic syndrome

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M is a 72 year-old widow with neprohritic syndrome, temporal arthritis, osteoporosis, severe hypertension and Myeloma. M has two daughters however she lives on her own. Her present complaints are: - itching, poor appetite, nausea, lower back pain and lethargy.


Multiple substances such as, water, urea, creatinine, uremic toxins, and drugs move from the blood into the dialysate, thus facilitating removal from the blood. Solutes are transported across the membrane by either passive diffusion or ultrafiltration. M also received 7 sessions of Plasma Exchange. Plasma Exchange is a procedure in which blood is separated into different parts: red cells, white cell, platelets and plasma. The plasma is removed from the blood and a plasma substitute replaced. M had chemotherapy. Chemotherapy is the treatment which uses anti-cancer drugs to kill cancer (Myeloma) cells. Myeloma is the cancer that affects cells in the bone marrow called plasma cells leading to damage to the kidney. Haemodialysis and Plasma Exchange will correct M's blood chemistry and therefore relieve her present symptoms.
M is hypertensive due to fluid overload or as a result of the failure of the kidneys. The Management of M's hypertension will have the highest priority. As Redmond and McClelland (2006) noted prompt recognition and treatment of hypertension are essential because cardiovascular disease including coronary artery disease, atherosclerosis, stroke and left ventricular hypertrophy are the most common cause of death in patients with kidney disease. ...
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