Case Study Analysis is of a 34-year-old Hispanic-American male diagnosed with End-stage Renal Disease
The case presented is of a 34-year-old Hispanic-American male diagnosed with end-stage renal disease who has since undergone a successful kidney transplant from a cadaver donor, as no one from his family was a good match. The patient then went back to work as a policeman after three months. However, six months after the transplant, he began exhibiting symptoms, including decreased urine output, fatigue, and intermittent fever spikes up to 101o F. These symptoms indicate acute kidney transplant rejection. This paper discusses the symptoms presentation, the gene associated with the disease, and the effect of immunosuppression.
Symptoms Presentation
Six months after the kidney transplant, the patient presented with weight gain, decreased urine output, fatigue, and fever (Vaillant, 2023). Firstly, weight gain can be associated with decreased urine output, leading to fluid retention. One primary function of the kidney is to filter excess waste and fluid in the body. The kidney’s primary function is crippled when rejection occurs, causing fluid retention and weight gain. Secondly, decreased urine output can be attributed to kidney dysfunction. It happens when the transplanted kidney is seen as a foreign body and is attacked by the body, which compromises the kidney’s ability to filter blood and yield urine (Vaillant, 2023).
Thirdly, fatigue can be related to several causes in the body. Anemia is one of them, given that it is common in patients with kidney transplant rejection because of decreased erythropoietin production by the failed kidney (Anemia in chronic kidney disease – niddk n.d). Moreover, the immune response against the transplanted kidney and body stress can cause fatigue. Lastly, fever symptom is a common sign of inflammation. Inflammation is part of the body’s immune response against a foreign body. Given that the immune system recognizes the new kidney as a foreign body, it initiates an inflammation response, which causes high temperature in the body (Vaillant, 2023).
Genes Associated with the Disease
Acute kidney rejection is mainly an immune-associated process, but some genes may be responsible for this disorder. The genes in the human leukocyte antigen system are responsible for tissue compatibility and immune response. The possibility of graft rejection can be affected if genetic polymorphisms exist in the human leukocyte antigen (Vaillant, 2023).
Immunosuppression and Its Effects
Immunosuppression decreases the immune system’s ability to respond to foreign antigens efficiently (Rice, 2019). It is caused by the blockage of antigen recognition pathways or other immune response elements and the killing of the immune effector cells. For instance, Tacrolimus and Cyclosporine suppress the activation of the T-lymphocytes, which inhibits the immune system’s ability to recognize and kill the transplanted kidney (Hussain & Khan, 2022). Subsequently, long-term use of immunosuppression makes a patient susceptible to cancers like B-cell non-Hodgkin lymphoma. Moreover, Rice (2019) adds that immunosuppressive drugs are associated with an increased risk of infections and metabolic disturbance.
Conclusion
In this case, it is evident that the patient’s immunity recognized the transplanted kidney as a foreign body and attacked it, causing dysfunction and inflammation, which explains the acute kidney transplant rejection. Following this, genetic factors associated with the immune system, like human leukocyte antigen genes, may cause transplant rejection. Subsequently, immunosuppression can be caused by multiple factors, but in this case, immunosuppressive medications are used to prevent transplant rejection. Immunosuppression should be treated cautiously, for the patient is susceptible to infection and other issues.
References
Hussain, Y., & Khan, H. (2022). Immunosuppressive drugs. In Elsevier eBooks (pp. 726–740). https://doi.org/10.1016/b978-0-12-818731-9.00068-9
Rice, J. M. (2019). Immunosuppression. Tumour Site Concordance and Mechanisms of Carcinogenesis – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK570319/#:~:text=Immunosuppression%20can%20result%20from%20killing,presents%20a%20risk%20of%20cancer.