EpistemisProgressive general wear
Specialty: General.
Why it occurs
- Advanced chronic kidney disease with insidious uremic syndrome (accumulation of uremic toxins that depress appetite, alter bone metabolism, and cause endothelial dysfunction)
- Chronic decompensated liver disease in the irreversible cirrhotic phase (decreased clearance of ammonia and portal toxins, inadequate assimilation of nutrients and chronic inflammation)
- Myelodysplasia or refractory senile or adult anemia (failure in hematopoiesis that limits cellular oxygenation and depresses vitality)
- Systemic fungal infections or chronic intestinal or tissue parasitosis (indolent course but with high consumption of host resources)
- Undiagnosed multisystem chronic inflammatory diseases in advanced stages.
Initial workup
Complete blood count with peripheral blood smear, erythrocyte sedimentation rate, C-reactive protein, urea nitrogen, creatinine, 24-hour urine creatinine clearance, liver profile, serum albumin, and total body computed tomography (thorax, abdomen, and pelvis).
red flags
Sudden loss of the ability to stand or walk due to extreme weakness, recurrent unexplained fever, spontaneous mucosal bleeding (gingivorrhagia, frequent epistaxis), or progressive confusion/lethargy.
Standard management
- Specialized high-density nutritional support with a balanced contribution of micronutrients and trace elements
- Recombinant human erythropoietin — under strict hematological or nephrological indication if there is anemia associated with advanced chronic kidney disease
- Paracetamol (500 mg orally as a general symptomatic to relieve diffuse discomfort and facilitate basic mobility).
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- General
- Listed causes
- 5
- Treatment options
- 3