The clinical manifestations currently present in the patient point to the possible development of chronic kidney condition, with immediate intervention required. First, the patient has some serious complaints about swelling, eventually being diagnosed with pitting edema in ankles and feet. The swelling, or edema, primarily occurs when the body contains excessive fluid. Since kidney function is responsible for removing waste material from the body, including water and sodium, it is reasonable to assume that swelling may be caused by a disruption in kidney function.
While edema may be relevant for other issues, such as poor diet and heart problems, the suspected kidney failure is also justified by the patient’s cholesterol levels. Thus, whereas the normal total cholesterol range shall not exceed 200 mg/dL, Mr. C.’s levels are currently at 250 mg/dL. The number of triglycerides in Mr. C. is nearly twice as high as the ideal range of 150 mg/dL, whereas the high-density lipoprotein levels are twice as low as the adult norm (US National Library of Medicine, n.d.). According to the researcher, such serious issues with cholesterol levels are highly associated with the risk of end-stage renal disease (Kim et al., 2017). The patient’s respiratory rate is slightly abnormal due to excessive weight, but his heart rate is within the normal range. The blood pressure is significantly elevated.
Obesity and Health Risks
The issue of obesity has been a prevalent health issue on a global level, and the tendency is not likely to change any time soon, as the statistics demonstrate a steady increase in the obesity rates (Kinlen et al., 2018). Apart from evident complications on the people’s vitals such as higher blood pressure and heart rate, obesity has a serious of potential complications that may be detrimental to human health and life expectancy. Such complications include but are not limited to diabetes, heart disease, dementia, and cancer (Kinlen et al., 2018). Moreover, obesity is a serious risk factor of chronic kidney disease (CKD), which stands for the gradual process of kidney function worsening and eventually leading to kidney failure when ignored (Kovesdy et al., 2017). For this reason, in order to avoid morbid implications of obesity and excessive weight, early intervention is vital.
In the case of Mr. C., the early intervention was ignored, as the patient considered the issue to be genetic. When looking at the medical record, there is no indication of the patient’s regular physical activity and healthy nutrition patterns, except for the attempts to cut on sodium in order to normalize blood pressure. While bariatric surgery may be a reasonable option for the patient, as his genetic predisposition to obesity, along with a possible kidney failure, limit the patient’s options for slower recovery with no surgical interference. Considering the patient’s condition, he is likely to struggle with end-stage renal disease (ESRD), so he requires dialysis and kidney transplant in the nearest future. According to the latest study, bariatric surgery considerably increases one’s chance to be eligible for a kidney transplant and benefit from dialysis (Soliman et al., 2021). Hence, it may be concluded that this type of surgery is a justifiable option for Mr. C.
Functional Health Patterns and Potential Issues
Considering the initial assessment of Mr. C., it becomes evident that his approach to health is not exactly rational, as he tends to justify his health with the help of external factors rather than embracing responsibility for health management. For this reason, the first problem associated with the functional health pattern of health management is the lack of self-actualization importance of one’s actions. If the patient continues to defend his health choices with genetics and other external factors, his health will deteriorate rapidly.
Secondly, the patient is likely to face cardiac complications due to his apnea that limits his physical activity yet elevates hypertension and risk for cardiac arrests and chronic conditions. The sleep and rest patterns are also disrupted by sleep apnea, and poor sleep leads to various health complications, including hypertension, diabetes, and cardiac issues (Worley, 2018). As an overweight young man in a fat-shaming and prejudiced society, Mr. C. is likely to have a series of body-image issues. Moreover, the existing health complications, especially if the ESRD diagnosis is justified, are prone to have a negative effect on his mental health. For this reason, coping mechanisms assessment and psychological interventions are compulsory in order to assist the patient. Finally, the elimination patterns of the patient are likely to cause some problems due to the existing kidney complications and cholesterol issues.
ESRD Staging and Contributing Factors
The ESRD is generally considered a final stage of kidney disease, as kidney failure is an irreversible process that requires kidney transplant and constant dialysis. Essentially, however, there are five significant stages of kidney disease:
- Healthy kidney function;
- Damage with mild loss in kidney function;
- Moderate loss of kidney function;
- Severe loss of kidney function;
- Kidney failure (Whiltney, 2018)
In order to define the stage, it is mandatory to run a blood test on glomerular filtration rate (GFR), as it demonstrates the amount of blood kidneys are capable of filtering each minute. The lower the GFR is, the more damaged the kidney is. Some of the most common contributing factors to ESRD include hypertension, obesity, pre-existing kidney dysfunctions, genetic predisposition, and such medical conditions as lupus erythematosus (Whitney, 2018). Hence, considering these factors, Mr. C.’s suspected kidney failure is once again justified by the risks associated with the disease.
ESRD Prevention and Education
While, in many cases, kidney disease can be neither avoided nor predicted, there exists a number of strategies to prevent its progression. Essentially, it is imperative to minimize the risks of diseases and habits that serve as contributing factors to kidney failure, including diabetes and hypertension. The patient’s current weight status is a serious threat to his health condition, so addressing the issue of obesity is vital in terms of minimizing such side conditions as diabetes, hypertension, and cancer. The health promotion, in this context, will concern the minimization of unhealthy habits such as poor diet, tobacco smoking, and substance abuse, as they have an adverse effect on the kidneys.
As far as patient rehabilitation is concerned, the primary options are dialysis and a kidney transplant. The first option will prolong the patient’s functioning with the ability to acquire a portable dialysis machine that could be used outside the hospital. In this case, it is imperative to educate patients on the lifestyle changes that come along with dialysis treatment, as it requires a strict diet and medication intake. While on dialysis, the patient should become a kidney transplant candidate. After rehabilitation lasting approximately eight weeks, the patient will be able to recover and gradually return to normal life.
Nonacute Care and Multidisciplinary Approach to Rehabilitation
An example of a nonacute care resource for ESRD patients is the ESRD Network that helps patients and families to assist the patient and monitor their care. As far as rehabilitation is concerned, it is vital to engage with a team of professionals, including a nephrologist, nurses, a physician, an occupational therapist, and a psychologist. They will be able to help the patient familiarize himself with possible life-supporting options, technology, occupational recovery techniques, and resources to address when in need of financial aid or employment.
References
Kim, M. K., Han, K., Koh, E. S., Kim, H. S., Kwon, H. S., Park, Y. M., Yoon, K.-H., & Lee, S. H. (2017). Variability in total cholesterol is associated with the risk of end-stage renal disease: A nationwide population-based study. Arteriosclerosis, Thrombosis, and Vascular Biology, 37(10), 1963-1970. Web.
Kinlen, D., Cody, D., & O’Shea, D. (2018). Complications of obesity. QJM: An International Journal of Medicine, 111(7), 437-443. Web.
Kovesdy, C. P., Furth, S. L., & Zoccali, C. (2017). Obesity and kidney disease: hidden consequences of the epidemic. Brazilian Journal of Nephrology, 39, 1-10. Web.
Soliman, B. G., Tariq, N., Law, Y. Y., Yi, S., Nwana, N., Bosetti, R., Kash, B., Moore, L. W., Gaber, A. O., & Sherman, V. (2021). Effectiveness of bariatric surgery in increasing kidney transplant eligibility in patients with kidney failure requiring dialysis. Obesity Surgery, 1-8. Web.
US National Library of Medicine. (n.d.). Cholesterol levels: What you need to know. Web.
Whitney, S. (2018). Elimination complexities. In Pathophysiology clinical applications for client health [E-book]. Grand Canyon University. Web.
Worley, S. L. (2018). The extraordinary importance of sleep: the detrimental effects of inadequate sleep on health and public safety drive an explosion of sleep research. Pharmacy and Therapeutics, 43(12), 758-763.