Name of the Procedure:

End-Stage Renal Disease (ESRD) Related Services Monthly
Common name(s): ESRD Monthly Care, Kidney Failure Management

Summary

Patients who have end-stage renal disease (kidney failure) often need continuous care. For adults aged 20 or older, this includes monthly services with at least four face-to-face visits from a physician or qualified health care professional.

Purpose

Addressed Condition: End-Stage Renal Disease (ESRD) Goals/Outcomes:

• Manage and monitor kidney function and overall health.
• Adjust and optimize ongoing treatment plans.
• Early identification and management of complications.

Indications

• Diagnosed with End-Stage Renal Disease.
• Requiring dialysis or transplant preparation.
• Complex medical needs due to ESRD.

Preparation

Pre-visit Instructions:

• Maintain existing dialysis schedule.
• List all current medications.
• No specific fasting required, unless specified by your healthcare provider.

Diagnostic Tests:

• Routine blood tests (e.g., electrolyte levels, kidney function markers).
• Regular monitoring of blood pressure and weight.

Procedure Description

1. Initial Consultation:
   • Review patient’s history and current health status.
   • Physical examination.
2. Monthly Visits:
   • Minimum of four face-to-face visits, each tailored to the patient’s needs.
   • Monitoring vital signs and reviewing lab results.
   • Consultation on medication adjustments and diet.
   • Discuss lifestyle changes and offer mental health support.
   • Managing dialysis access sites and potential issues.

Tools Used:

• Blood pressure cuffs, stethoscopes, blood sample kits.

Anesthesia: Not applicable.

Duration

Each visit typically lasts 30-60 minutes, depending on the patient’s needs.

Setting

These visits can be performed in various settings, including:

• Outpatient clinics.
• Dialysis centers.
• Hospital outpatient departments.

Personnel

• Physicians specializing in nephrology.
• Registered nurses.
• Dietitians.
• Social workers and mental health professionals if required.

Risks and Complications

• Common Risks: Minor discomfort during blood draws.
• Rare Risks: Infection at access sites, missed complications if visits are too infrequent.
• Management: Prompt follow-up with concerns.

Benefits

• Enhanced management of ESRD.
• Improved quality of life.
• Prevention or early detection of complications.
• Potential stabilization of kidney function.

Recovery

• No specific recovery period.
• Routine lifestyle with careful attention to dietary and medication adherence.
• Regular follow-up appointments as scheduled.

Alternatives

• Less frequent visits: May lead to inadequate monitoring.
• Self-management: Possible, but less recommended due to complexity.
• Increased in-person care: More frequent visits, if needed based on patient condition.

Pros and Cons of Alternatives:

• Less frequent visits may lower burden but increase risks.
• Self-management places more responsibility on patient.
• Increased care could be more comprehensive but time-consuming.

Patient Experience

During the Procedure:

• Generally, non-invasive and involves regular check-ups.
• Clearly communicate any symptoms or concerns.

After the Procedure:

• Patients are encouraged to maintain open communication with their healthcare team.
• Pain management is minimal, usually involving managing any discomfort from blood draws.

Comfort Measures:

• Open dialogue with the healthcare provider.
• Support from the care team to address any concerns or discomfort.