90955 End-stage renal disease (ESRD) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or ot

Name of the Procedure:

End-Stage Renal Disease (ESRD) Related Services Monthly for Patients 2-11 Years of Age

Summary

This procedure involves regular monthly monitoring and management for children aged 2-11 who have end-stage renal disease. It includes assessing their nutritional needs, monitoring growth and development, and providing counseling to parents. The management typically involves 2-3 face-to-face visits with a physician or healthcare provider each month.

Purpose

ESRD related services aim to:

• Ensure adequate nutrition and proper growth in children with ESRD.
• Monitor the progress and overall health of the child.
• Provide guidance and counseling to parents to support their child's care and well-being.

Indications

• Diagnosis of End-Stage Renal Disease (ESRD) in children aged 2-11.
• Symptoms include impaired kidney function, failure to thrive, and developmental delays.
• Patients requiring close medical supervision and nutritional monitoring.

Preparation

• Parents may need to maintain a dietary log and record any symptoms.
• Routine blood tests or other diagnostic assessments to track kidney function and nutritional status.

Procedure Description

1. Initial Assessment: Review of the child's medical history and recent test results.
2. Nutritional Monitoring: Evaluate dietary intake, recommend nutritional supplements, and dietary adjustments necessary for optimal growth.
3. Growth and Development: Assess physical and cognitive development parameters.
4. Parent Counseling: Advise on best practices for managing the child's condition at home, including dietary and activity guidelines.
5. Regular Visits: 2-3 face-to-face visits per month to monitor progress and adjust care plans as needed.

Duration

Each face-to-face visit typically lasts about 30-60 minutes. The monthly management and monitoring occur over the course of the child's treatment period.

Setting

These services are usually performed in an outpatient clinic or a specialized nephrology center.

Personnel

• Pediatric nephrologist or specialized physician
• Dietitian or nutritionist
• Nurses specialized in nephrology

Risks and Complications

• Potential for nutritional imbalances or failure to meet growth milestones if not correctly monitored.
• Emotional and psychological stress for the child and family.
• Rarely, adverse reactions to nutritional supplements.

Benefits

• Improved management of ESRD in children.
• Promotion of growth and development.
• Enhanced parental understanding and capability to manage the child's condition.

Recovery

• Ongoing management rather than a finite recovery phase.
• Regular follow-ups and adjustments based on the child's progress.
• Parents may be given specific at-home care instructions and dietary guidelines to follow.

Alternatives

• Peritoneal dialysis or hemodialysis.
• Kidney transplant as a long-term solution.
• Nutritional counseling and growth monitoring without frequent medical visits, though less effective.

Patient Experience

• During visits, children may undergo physical examinations and growth assessments.
• Parents may help the child adhere to dietary recommendations and manage daily routines.
• Efforts are made to keep the child comfortable, and any discomfort from blood tests or examinations is minimized through pain management techniques.