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[ANSWERED] A 34-year-old Hispanic-American male with end-stage renal disease received a kidney transplant from a cadaver donor, as no one in his family was a good match

Module 1 Assignment: Case Study Analysis

An understanding of cells and cell behavior is a critically important component of disease diagnosis and treatment. But some diseases can be complex in nature, with a variety of factors and circumstances impacting their emergence and severity.

Effective disease analysis often requires an understanding that goes beyond isolated cell behavior. Genes, the environments in which cell processes operate, the impact of patient characteristics, and racial and ethnic variables all can have an important impact.

An understanding of the signals and symptoms of alterations in cellular processes is a critical step in the diagnosis and treatment of many diseases. For APRNs, this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify cell, gene, and/or process elements that may be factors in the diagnosis, and you explain the implications to patient health.

To prepare:

By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

The Assignment (1- to 2-page case study analysis)

Develop a 1- to 2-page case study analysis in which you:

  • Explain why you think the patient presented the symptoms described.
  • Identify the genes that may be associated with the development of the disease.
  • Explain the process of immunosuppression and the effect it has on body systems.

Scenario 3: A 34-year-old Hispanic-American male with end-stage renal disease received a kidney transplant from a cadaver donor, as no one in his family was a good match. His post-operative course was uneventful, and he was discharged with the antirejection drugs Tacrolimus (Prograf), Cyclosporine (Neoral), and Imuran (Azathioprine). He did well for 3 months and had returned to his job as a policeman. Six months after his transplant, he began to gain weight, had decreased urine output, was very fatigued, and began to run temperatures up to 101?F. He was evaluated by his nephrologist, who diagnosed acute kidney transplant rejection.

Expert Answer and Explanation

Kidney Transplant Issues

Causes of the Presented Symptoms

The patient experience the presented symptoms due to the following reasons. First, he experienced weight gain because he had a kidney problem. The function of healthy kidneys is to remove excess waste from the body in terms of fluid. Kalantar-Zadeh et al. (2017) note that people with kidney problems often gain weight because their kidneys are not healthy enough to excrete excess body fluid. In other words, the patient in the case gained weight because he has a lot of waste fluid on his body. Second, poor working kidneys low amount of urine. Hence, the patient complained of decreased urine output because his kidneys are not healthy and poorly functional. Third, Kalantar-Zadeh et al. (2017) note that severe kidney problems can make one’s blood have impunities and toxins and make the individual feel weak, tired, and difficult to concentrate. Severe kidney problem also causes anemia, which can lead to fatigue. Hence, the patient was experiencing fatigue because of impunity and toxins in his blood and anemia caused by his kidney problem. Severe kidney problems can cause a condition known as sepsis link, which can cause a high fever. The patient might be experiencing fever due to the sepsis link caused by his kidney failure.

Genes Linked to Development of Acute Kidney Transplant Rejection

Several genes are linked to the development of acute kidney transplant rejection. One of the genes is the human cytokine synthesis inhibitory factor also known as IL-10. Li et al. (2018) note that IL-10 is generally known as an anti-inflammatory cytokine that is responsible for stopping inflammation after a person has undergone an allograft. However, the authors note that this gene is responsible for causing acute rejection in kidney transplants by preventing the maturation of antigen-presenting cells, cells responsible for developing immunity. Another gene that is associated with acute kidney rejection is IL-10 polymorphism. Moudi et al. (2018) note that this gene can make one’s body reject newly introduced organs by preventing the secretion of IL-10, hence affecting the body’s immunity’s response to severe conditions. The gene is known to cause a difference in one’s immune system and trigger the body to fight introduced organs. ATP-binding cassette, subfamily B, member 1 is another gene linked to kidney transplant rejection. The gene is known for prompting many foreign substances including introduced organs out of the cells. It can also prompt the body to resist drugs prescribed to treat a patient after a kidney transplant (Dorr et al., 2018).

The Process of Immunosuppression and Its Effects on the Body Systems 

Immunosuppression can be defined as a situation where the body’s capacity to neutralize diseases and infections is reduced. It can also be defined as the suppression of one’s immune system, hence affecting its ability to fight diseases and infections (Arshad et al., 2017). It is often induced with medications, especially when one is being prepared for an organ transplant or bone marrow transplant. This process has many effects on the body systems. One of the effects of this process is repeated infections. People with suppressed immunity often develop a situation where they can experience recurrent infections. The process can also lead to more severe infections or diseases that can lead to death (Saghazadeh & Rezaei, 2020). The process can also lead to prolonged infections that do not health faster and increase one’s risk of developing cancer problems.


Arshad, L., Jantan, I., Bukhari, S. N. A., & Haque, M. (2017). Immunosuppressive effects of natural α, β-unsaturated carbonyl-based compounds, and their analogs and derivatives, on immune cells: a review. Frontiers in Pharmacology8, 22.

Dorr, C. R., Oetting, W. S., Jacobson, P. A., & Israni, A. K. (2018). Genetics of acute rejection after kidney transplantation. Transplant international : official journal of the European Society for Organ Transplantation31(3), 263–277.

Kalantar-Zadeh, K., Rhee, C. M., Chou, J., Ahmadi, S. F., Park, J., Chen, J. L., & Amin, A. N. (2017). The obesity paradox in kidney disease: how to reconcile it with obesity management. Kidney International Reports2(2), 271-281.

Li, J., Tang, Y., Tang, P. M., Lv, J., Huang, X. R., Carlsson-Skwirut, C., … & Lan, H. Y. (2018). Blocking macrophage migration inhibitory factor protects against cisplatin-induced acute kidney injury in mice. Molecular Therapy26(10), 2523-2532.

Moudi, B., Heidari, Z., Mahmoudzadeh-Sagheb, H., & Moudi, M. (2018). Analysis of interleukin-10 gene polymorphisms in patients with chronic periodontitis and healthy controls. Dental Research Journal15(1), 71–79.

Saghazadeh, A., & Rezaei, N. (2020). Towards treatment planning of COVID-19: Rationale and hypothesis for the use of multiple immunosuppressive agents: Anti-antibodies, immunoglobulins, and corticosteroids. International Immunopharmacology84, 106560.

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