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
CPT4 code
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
- Initial Assessment: Review of the child's medical history and recent test results.
- Nutritional Monitoring: Evaluate dietary intake, recommend nutritional supplements, and dietary adjustments necessary for optimal growth.
- Growth and Development: Assess physical and cognitive development parameters.
- Parent Counseling: Advise on best practices for managing the child's condition at home, including dietary and activity guidelines.
- 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.