Immunosuppressant treatment 1. Identification and description of the procedure
The immunosuppressant treatment consists in administering pharmaceutical intravenously or orally amongthose corticoids, cyclophosphomide, azathioprine, mycophenalate, cycloseporine, chlorambucil, tacrolymus,rapamycin and others. Your team of nephrologists will have informed you of the disease you are sufferingfrom and which is the most appropriate combination to be able to control your disease. 2. Purpose of the procedure and benefits that are expected to be achieved
The objective is the immunosuppressant treatment is to lower the potency and effectiveness of yourdefences with the purpose of diminishing the inflammation that is affecting your kidneys and probablythe other organs in your body.
The expected benefit of the treatments is to detain the progression of your disease and the evolutiontowards a renal insufficiency and dialysis, even though on occasions it may necessary to change or associateother more potent treatments. 3. Reasonable alternatives to this procedure
At the current moment we do not have any effective treatments that assure the detainment of theprogression of your disease. 4. Foreseeable consequences of its performance
It does not produce any foreseeable negative consequence. In cases of not performing it, we would loosediagnosis or follow-up information that could be important for follow-ups and correct treatment. 5. Foreseeable consequences of its non performance
Your team of nephrologists considers the immunosuppressant treatment to be commenced; its non-establishment could implicate the total loss of kidney function, requiring starting dialysis and in functionof the illness a mortality risk that could reach 90% of the year without treatment. 6. Frequent risks
The most frequent risks, in the initial phase of the treatment, are the derivates in the defence diminishmenttherefore the risk of infection is higher (cystitis, pneumonias, cutaneous infections by Herpes virus, etc). Likewise, and specially related to treatment with corticoids, Diabetes can appear (sugar in he blood),osteoporosis (loss of Calcium in the bones), cutaneous alterations (weakness in the skin, acne and swellingin the face)weight increase etc. 7. Infrequent risks.
The over all mortality rate related with the immunosuppressant treatment is less than 5% annually andgenerally is found in relation to the appearance of severe infections (severe pneumonias, tuberculosis,fungus infections, etc) and with the appearance of tumours. All of it due to the diminishment of thedefences. In any case, the nephrologists that tend you are knowledgeable in these possible effects andwill perform the necessary measures and the adequate follow-up to minimize the risk. 8. Risks depending on the patient's clinical situation
Other risks or complications that might appear, given your clinical situation and your personal circumstances,
SPECIALITY IN NEPHROLOGY Immunosuppressant treatment 9. Declaration of consent
Mr./Mrs./Miss. aged , with home address at
Mr./Mrs./Miss. aged , with home address at
acting in the capacity of (the patient's legal representative, relative or close
friend) , with National Identity No.
That the Doctor has explained to me that it is advisable/necessary in my
Signed: Mr./Mrs./Miss. With National Identity Card No
Signed: Dr. With National Identity Card No
10. Revocation of the consent
I hereby revoke the consent granted on the date of , 2 and I do not wish
to carry on with the treatment that I hereby terminate on this date. SPECIALITY IN NEPHROLOGY
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2013-2014 STUDENT INJURY AND SICKNESS INSURANCE PLAN Monterey Institute of International Studies Important: Please see the Notice on the first page of this plan material concerning student health insurance coverage. 12-BR-CA 04-200418-73 Notice Regarding Your Student Health Insurance Coverage Your student health insurance coverage, offered by UnitedHealthcare Insurance Compan