by Dr. E. Fleischmann Department of Clinical Medicine IV, Division of Nephrology and Hypertensiology, Friedrich-Alexander University Erlangen-Nuremberg Erlangen, Germany
A 57 year old woman treated with CAPD for ESRD due to FSGS presented with complaints of weight gain, edema, reduced physical well-being and loss of appetite. She started CAPD 42 months ago. Concomitant diseases were arterial hypertension, goiter and hysterectomy due to myoma. On examination her blood pressure was 142/87 mm HG, heart rate 73 bpm, bodyweight 81,5 kg, normal SI and SII, without murmur, respiration was unremarkable, she had + peripheral edema. At present she was using as PD prescription a fill volume of 2000 ml with glucose concentration of 1x 2,27 %, 2 x 3,86% and 1 x icodextrin revealing an ultrafiltration of 1350 mls per day with residual urine volume of 200 ml.
Laboratory: Hemoglobin 10,3 g/L, Erythrocytes 3,25 mio/µl, wbc 8,62 x 10 3/µl, thrombocytes 398 8,62 x 10 3/µl, creatinine 9,48 mg/dl, urea 56 mg/dl, albumin 3,13 g/dl, sodium 139 mmol/l, potassium 3,92 mmol/l, calcium 2,51 mmol/l, phosphate 4,49 mmol/l , CaxPo4 45,1, iPTH 239 pg/ml, CRP 0,90 mg/dl
Question 1) - What information is needed for further work up of the patient?