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RSA Conference 2024
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Managing multiple diagnoses and treatments: a case study of a patient with lupus and end stage kidney disease.

Concurrent

Concurrent

9:55 am

15 June 2024

P10

Session 9b: Concurrent 3.1

Talk Description

497C - Research Paper

Abstract
Case Description:
This is a case of 36-year-old man with a past medical history of Systemic lupus erythematosus, which was diagnosed in 2011 and later flared up in 2015 leading to a number of complications such as pancytopenia and thrombolytic microangiopathy. They were treated with plasma exchange, Intravenous immune globulin, IV cyclophosphamide, rituximab and eculizumab. Creatinine was 228 mmol/l, eGFR 32 ml/min/1.73m2 and platelet count was 142 x 109/L. In 2017, they later developed fatty liver disease and subclinical hypothyroidism. Creatinine and eGFR improved to 189 mmol/l and 40 ml/min/1.73m2 respectively. In 2021, they had another flare up requiring plasma exchange and eGFR continued to deteriorate. In 2023, hemodialysis was started using a permcath.

Description:
Successful management of this patient required collaboration across multiple disciplines such nephrology, haematology, neurology, infectious diseases and nursing. Medical management involved innovative treatment approaches which required regular monitoring and intervention. Most importantly, the patient and caregiver involvement was crucial when navigating complex healthcare settings. Even though the patient was known in the hospital system for over 10 years, they started dialysis with a permcath. Reasons for this include the competing needs in managing this complex condition. 

Conclusion:
Effective collaboration among healthcare professionals is crucial when managing patients with complex diagnoses. Participation of patients and caregivers need to be promoted. 

Presenters