End Stage Renal Disease: The Daily PANCE Blueprint

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End Stage Renal Disease: The Daily PANCE Blueprint

A 58-year-old male with a history of chronic kidney disease presents with shortness of breath, peripheral edema, and elevated blood pressure. His laboratory results show an estimated glomerular filtration rate (eGFR) of 12 mL/min/1.73m². He is requiring increasing amounts of oxygen. He was given diuretics with no response. Which of the following best describes his condition and appropriate management?

A. Acute kidney injury; manage with IV fluids
B. End-stage renal disease; initiate dialysis for volume removal
C. Chronic kidney disease stage 3; treat with more aggressive IV diuretics
D. Prerenal azotemia; manage with vasopressors and fluid resuscitation
E. Hypertensive emergency; initiate intravenous nitroprusside infusion

Answer and topic summary

The answer is B. End-stage renal disease; initiate dialysis for volume removal

End-stage renal disease is defined as irreversible kidney dysfunction with an estimated glomerular filtrate rate of less than 15 mL/min/1.73m with manifestations of uremia requiring renal replacement therapy or renal transplantation. Complications include hypertension, fluid retention, ventricular dysfunction, anemia, iron deficiency, hyperparathyroidism, increased infection, hyperphosphatemia, calcium disorders, and thrombocytopenia. Patients with ESRD who have worsening volume-overload signs should be sent to dialysis for volume removal.

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Covered under ⇒ PANCE Blueprint Renal System ⇒ End Stage Renal Disease (ESRD)

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