ESRD: The Daily PANCE Blueprint

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ESRD: The Daily PANCE Blueprint

A 62-year-old male with a history of ESRD (on dialysis for 3 years) presents to the ER with worsening shortness of breath. A CXR reveals bilateral airspace opacities and bilateral pleural effusions. He is placed on 5L NC with now a SpO2 of 95%. Which of the following is the most appropriate intervention at this time?

A. Hemodialysis
B. Continue to observe
C. Administration of high-dose steroids
D. Endotracheal intubation
E. None of the above

Answer and topic summary

The answer is A. Hemodialysis

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 also manifestations of uremia requiring renal replacement therapy or renal transplantation. Complications include hypertension, fluid retention, ventricular dysfunction, anemia, iron deficiency, hyperparathyroidism, increased infection, hyperphosphataemia, 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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Smarty PANCE Content Blueprint Review:

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

Also covered as part of the Internal Medicine EOR, Emergency Medicine EOR, and General Surgery topic lists

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