Name of the Procedure:

End-stage renal disease (ESRD) related services monthly for patients 2-11 years of age with 1 face-to-face visit by a physician or other healthcare provider.

Summary

This procedure involves monthly services for children aged 2-11 years with end-stage renal disease (ESRD). It includes monitoring their nutrition, assessing their growth and development, and counseling their parents. A physician or another healthcare provider conducts at least one face-to-face visit with the patient each month.

Purpose

The procedure addresses the comprehensive care needs of children with ESRD. The goals are to ensure adequate nutrition, monitor growth and development, manage symptoms, and provide support and counseling to parents.

Indications

• Diagnosis of end-stage renal disease (ESRD).
• Requirement for ongoing nutritional monitoring.
• Need for regular assessment of growth and development.
• Parental need for counseling and support.

Preparation

• No specific fasting or medication adjustments are usually required.
• Regular lab tests or assessments may be conducted as part of routine care for children with ESRD.

Procedure Description

1. The healthcare provider conducts a thorough review of the patient's nutritional status, growth, and development.
2. The physician or healthcare provider performs a physical examination during the face-to-face visit.
3. The patient's lab results and any other diagnostic tests are reviewed.
4. Parents are counseled about the child's condition, treatment plan, and any necessary lifestyle adjustments.
5. Recommendations for diet, medications, and any other interventions are made based on the assessment.

Duration

The face-to-face visit typically lasts between 30 minutes to 1 hour, but this can vary depending on the complexity of the patient's needs.

Setting

This procedure is generally performed in an outpatient clinic or a pediatric nephrology office.

Personnel

The team involved may include:

• Pediatric nephrologist or another specialized physician
• Pediatric nurse
• Dietitian
• Social worker, if necessary

Risks and Complications

• General discomfort during the physical exam.
• Emotional stress for the child and parents.

Complications are rare but might include:

• Misinterpretation of growth data without proper context.
• Overlooked nutritional deficiencies if not appropriately monitored.

Benefits

• Ensures ongoing monitoring and adjustment of treatment plans for optimal care.
• Early detection of growth or nutritional issues.
• Provides continuous support and education for parents.
• Improves overall quality of care and life expectancy for children with ESRD.

Recovery

• Usually no recovery time is needed as it's a non-invasive assessment.
• Continuous monitoring is part of the management of ESRD.

Alternatives

• More frequent visits if deemed necessary by the healthcare provider.
• Home monitoring programs with regular telehealth consultations.
• In severe cases, consideration of renal replacement therapies like dialysis or kidney transplantation.

Patient Experience

• The child may feel nervous or uncomfortable but efforts will be made to ensure they feel safe and well-supported.
• Parents will receive thorough explanations and guidance.
• Pain is generally not an issue, but emotional support is crucial for both child and family.