Case Study on Obesity and Kidney Failure

This case study discusses the clinical manifestation of obesity and risk of kidney failure in Mr C. It also highlights the potential health risks associated with obesity and the appropriate intervention to prevent it. The study also covers the functional health patterns of Mr C and preventive measures for ESRD.

Running head: CASE STUDY
CASE STUDY
Name of Student:
Name of University:
Author’s Note:

1CASE STUDY
Answer number 1.
It is evident from the case study that Mr C is obese and looking to go for the bariatric
surgery. The clinical manifestation that can be observed in Mr C linked to obesity are sleep
apnoea, high blood pressure, shortness of breath, swollen ankles and pruritus. Concerning his
objective data, he has the weight of 134.5 kg and height of 68 inches. According to the study of
Depczynski, Young and White (2018) BMI above 25 is regarded as obese, and on calculating his
BMI is 45.5 which proves for obesity in Mr C. Normal blood glucose level in human lies in the
range of 100mg/l, and as per the objective data he has 146mg/l blood glucose level, which
indicates that Mr C is diabetic.
Further, the functioning of his kidney is impaired as he has high serum creatinine of
1.8mg/l and Blood Urea Nitrogen of 32mg/dl (Pandya, Nagrajappa & Ravi, 2016). Such
dysfunction of the kidney is also associated with his obesity which is related to his high total
cholesterol level, triglyceride and low HDL. Due to increased weight, his respiratory rate is also
high which accounts to 21/min. Therefore, the clinical manifestation indicates obesity and risk of
kidney failure in Mr C.
Answer number 2.
Mr C is reported to be obese and is associated with various health risk. According to the
study of Mandviwala, Khalid and Deswal (2016) people who are diagnosed with obesity are at
high risk of diabetes, hypertension and other health complication. As per the laboratory data of
Mr C, he has high blood glucose level and high blood pressure, thus have the potential to acquire
type 2 diabetes. It is evident from the study of Kovesdy, Furth and Zoccali (2017) that in the
person affected by obesity, there is the occurrence of compensatory hyperfiltration in order to

2CASE STUDY
meet the metabolic demand of the increasing body weight. This, in turn, increases the
intraglomerular pressure and have the potential to damage the kidney. It is seen that Mr C has
high serum creatinine and elevated blood urea nitrogen, he is also at the risk of kidney failure. It
is noted that he has high total cholesterol and high triglyceride and low HDL, which can cause
coronary blockage, thus can lead to cardiovascular complication (Chuengsamarn et al., 2017).
Williams et al. (2015) have stated that bariatric surgery is performed in a person who has a BMI
above 40 and however it is associated with severe health risk. Thus, concerning his case and
health risk, bariatric surgery is proved to be an appropriate intervention to prevent obesity in Mr
C.
Answer number 3.
Concerning to the case study, the five functional health patterns of Mr C observed are
health management, health perception, nutritional, metabolic and elimination. It is noted that Mr
C has health perception is potential problem because as he does not have sleep apnea and high
blood pressure but still take low sodium diet and it could lead to dehydration. Health
management is also potential problem because without being suggested for bariatric surgery he
seeking information regarding it, hence it could lead to severe health complication like heart
failure. Nutrition being another functional health pattern is other actual problem because as it is
evident from the study of Batsis et al. (2015) that due to low sodium intake, there is electrolyte
imbalance, and there is the release of renin is obstructed which causes low blood pressure.
Metabolic is regarded as potential problem as change in diet lead to low blood volume that
causes dysfunction in pulmonary and systematic circulation leading to heart failure. Elimination
is viewed as actual problem because low absorption of sodium can impact the glomerular

3CASE STUDY
filtration and increases the arteriole pressure thus may lead to kidney failure (Ray et al., 2015).
Electrolyte imbalance causes release of high ADH level; thus, have the potential to cause
dehydration and dizziness.
Answer number 4.
In stage one, there is mild damage to kidney with EGFR of 90ml/min and above. In
second stage, the EGFR is in the range of 60ml/min to 80ml/min, which shows initial period of
damage of kidney function. The third stage, the GFR get decreased to 45-59ml/min where there
is a need to consider the build of the waste product which shows a sign of the change of urination
color. The fourth stage has GFR of 15-30ml/min and needs dialysis or kidney transplantation. In
the last stage, the GFR become less than 15ml/min which is the advanced stage of kidney failure.
The contributing factor for each of the stages is advanced age, hypertension, diabetes, obesity
and low oxygen saturation level respectively (Ayav et al., 2016).
Answer number 5.
ESRD is the lethal disease which can lead to kidney damage. Patient education is one of a
preventive measure for ESRD. The patient will be given education-related to self-management
and implementation of precautions for health promotion. The patient will be given the education
to control diabetes and maintain high blood pressure (Devoe et al., 2016). Education about the
healthy diet and physical activity will also be provided so that management of health is done
effectively. Further, patient will be taught to maintain a healthy weight by performing physical
exercise for 30 min. The patient will be given education about the side effect of ESRD and sign
and symptoms, so that patient can immediately contact in emergency department.

4CASE STUDY
Answer number 6.
The resource available for the ESRD patients is ambulance service, community service
like domestic service to help the patient with daily living activities, availability of dialysis device
and instrument and community diver for secure transportation of ESRD patient in need. The
multidisciplinary approach also has a benefit to the ESRD patient (Mercado‐Martinez et al.,
2017). By the involvement of the psychologist, the patient will be able to cope with the illness.
They also motivate the patient towards their daily life and also address the return-to-employment
issues. The presence of physiotherapist also helps the patient to manage weight effectively. A
nutritionist can assist the patient regarding the maintenance of a healthy diet. Such a
multidisciplinary approach helps to maintain the health of the ESRD patient and thus promote
their wellness.

5CASE STUDY
Reference
Ayav, C., Beuscart, J. B., Briançon, S., Duhamel, A., Frimat, L., & Kessler, M. (2016).
Competing risk of death and end-stage renal disease in incident chronic kidney disease
(stages 3 to 5): the EPIRAN community-based study. BMC nephrology, 17(1), 174.
Batsis, J. A., Mackenzie, T. A., Lopez-Jimenez, F., & Bartels, S. J. (2015). Sarcopenia,
sarcopenic obesity, and functional impairments in older adults: National Health and
Nutrition Examination Surveys 1999-2004. Nutrition research, 35(12), 1031-1039.
Chuengsamarn, S., Rattanamongkolgul, S., Sittithumcharee, G., & Jirawatnotai, S. (2017).
Association of serum high-sensitivity C-reactive protein with metabolic control and
diabetic chronic vascular complications in patients with type 2 diabetes. Diabetes &
Metabolic Syndrome: Clinical Research & Reviews, 11(2), 103-108.
Depczynski, B., Young, T., & White, C. (2018). A high ankle-brachial index is associated with
obesity and low serum 25-hydroxyvitamin D in patients with diabetes. Journal of clinical
& translational endocrinology, 11, 7-10.
Devoe, D. J., Wong, B., James, M. T., Ravani, P., Oliver, M. J., Barnieh, L., ... & Quinn, R. R.
(2016). Patient education and peritoneal dialysis modality selection: a systematic review
and meta-analysis. American Journal of Kidney Diseases, 68(3), 422-433.
Kovesdy, C. P., Furth, S., & Zoccali, C. (2017). Obesity and Kidney Disease Hidden
Consequences of the Epidemic (Special Report).
Mandviwala, T., Khalid, U., & Deswal, A. (2016). Obesity and cardiovascular disease: a risk
factor or a risk marker?. Current atherosclerosis reports, 18(5), 21.

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Mercado‐Martinez, F. J., da Silva, D. G. V., & Correa‐Mauricio, M. E. (2017). A comparative
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and obesity: prevalence, consequences, and causes of a growing public health
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