Factors Affecting the Management of Hyperphosphatemia in Patients Awaiting Kidney Transplantation: Two Case Studies

Abstract

Hyperphosphatemia affects chronic kidney disease-mineral and bone disorder (CKD-MBD), causing mineral and hormonal disorders such as secondary hyperparathyroidism, bone disorders, and vascular calcification. Most patients have no symptoms until the disease progresses and is difficult to resolve, which makes it a very dangerous silent threat among patients waiting for a kidney transplant. If the patient has consistently high phosphate levels in the blood, it can lead to severe long-term complications that can lead to the delay or termination of kidney transplant surgery.

Therefore, it is important to control phosphates in the blood to meet the target criteria. To address such issues, the health team must understand the root issues that affect phosphatemia. The purpose of this paper was to study the factors affecting the management of hyperphosphatemia among patients waiting a kidney transplant by reviewing empirical evidence using the PICO Framework and assessing the quality of evidence using the Joanna Briggs Institute Levels of Evidence criteria, 2014. A literature review produced a total of 17 relevant articles. A review of the empirical evidence revealed that there were three main factors: 1. patient factors 2. therapeutic factors, and 3. health system factors. Each factor consisted of both positive and negative factors. This paper also presents a comparative analysis of two case studies of patients waiting for a kidney transplant to provide a clearer understanding of the factors affecting the management of hyperphosphatemia in real-world situations. The knowledge gained will lead to the efficient design of care plans for patients with such problems which are in line with the actual causes of their hyperphosphatemia.