How soon would it be recommended that each of these tests be included in the patients care plan moving forward?

Among your duties this week,
you have been invited to participate in an initial team meeting with a 15-year-old male patient and his
parents. This patient is at-risk of developing autosomal dominant polycystic kidney disease (ADPKD) as
his father was diagnosed recently. This patient is currently asymptomatic and reports no clinical signs of
disease. In this initial meeting the family and healthcare team will be discussing, among other things,
need for long term laboratory testing associated with the disease (for screening, monitoring and
diagnosis).
According to the consensus statement by Gimpel et al., “children with ADPKD may not require
treatment for decades [but] individuals who have disease manifestations […] will benefit from treatment
started as early as possible. […] An important dilemma in the medical care of children with ADPKD is the
balance between not medicalizing currently healthy individuals and not missing treatable disease
manifestations in those affected at an early age.”1
Using the resources provided with this assignment and those researched on your own (at least 1 and up
to 4 additional resources), develop an outline, a sort of script, for yourself in the format of your choice
where you are prepared to answer the following queries during the patient-family-team meeting:
• What laboratory tests are available for screening, diagnosis and monitoring of ADPKD?
• Which of these are most helpful in children and young adults?
• How soon would it be recommended that each of these tests be included in the patients care
plan moving forward?
• What evidence is there of the advantages or disadvantages of using one test instead of the
other? (consider that your patient’s parents are hourly workers whose jobs do not provide
health insurance. Would these tests be covered by Medicaid and if so which ones? How
expensive can it get?)
• If the patient has complications from ADPKD, what would the most common ones be and how
will the clinical laboratory help in managing these conditions?
• At least one additional question that, after reading the literature, you consider may come up in
the conversation that would be relevant to laboratory testing and its role to manage this
patient.

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