• ESRD—secondary to PKD and failed previous transplant

• One prior renal transplant from husband in 1995, which failed secondary to chronic allograft nephropathy in 2004 (presumably from multiple rejection episodes within the first few years after transplant).

• For the previous transplant the patient was maintained on cyclosporine, mycophen-olate, and prednisone.

• Hypertension; hyperlipidemia; insomnia

FH: Father died of a myocardial infarction at age 53, while her mother is alive and living with hypertension, systemic lupus erythematosus, DM, and osteoporosis at the age of 75.

SH: The patient works as a secretary. Was a heavy tobacco user (45 pack years), but quit 3 years ago. She denies alcohol and IV drug use.

Admission Meds: Calcitriol 0.25 mg by mouth once a day; calcium acetate 1,334 mg by mouth three times a day; ferrous sulfate 325 mg by mouth once a day; epo 4,000 units IV every hemodialysis session; zocor 20 mg by mouth once a day at bedtime; metoprolol 100 mg by mouth twice a day; ASA 81 mg by mouth once a day; zolpidem 10 mg by mouth once a day at bedtime

Allergies: Codeine (upset stomach); penicillin (hives); sulfa (rash) Misc:

• CMV serostatus: Donor is CMV immunoglobulin G (IgG) positive

• CMV serostatus: Recipient is CMV IgG positive Identify your treatment goals for this patient.

Create a plan for induction therapy (i.e., would you recommend induction therapy, if so, which agent?).

Anxiety and Depression 101

Anxiety and Depression 101

Everything you ever wanted to know about. We have been discussing depression and anxiety and how different information that is out on the market only seems to target one particular cure for these two common conditions that seem to walk hand in hand.

Get My Free Ebook

Post a comment