Name of the Procedure:

End-stage renal disease (ESRD) related services monthly, for patients 20 years of age and older; with 2-3 face-to-face visits by a physician or other qualified health care professional per month.

Summary

This monthly medical service involves routine management and care for patients aged 20 and older who have end-stage renal disease (ESRD). It includes 2-3 face-to-face visits per month with a physician or other qualified healthcare professional to monitor and manage the patient's condition effectively.

Purpose

Addresses: Chronic kidney failure where the kidneys no longer function adequately to meet the body's needs. Goals: To manage symptoms, slow disease progression, monitor treatment effectiveness, and improve quality of life for ESRD patients.

Indications

• Diagnosed ESRD requiring ongoing medical management.
• Need for regular monitoring and adjustments in treatment plans.
• Frequent assessment of dialysis effectiveness, medications, and overall health status.

Preparation

• Patients may need to keep a log of daily symptoms and treatments.
• Bring current medication list and dialysis records to appointments.
• No specific fasting or medication adjustments are typically required before routine visits.

Procedure Description

1. Initial Consultation: Review patient history, dialysis records, and any symptoms or concerns.
2. Physical Examination: Check vital signs, assess dialysis access sites, and evaluate overall health.
3. Diagnostic Review: Analyze recent lab results, imaging, and other relevant tests.
4. Treatment Plan: Adjust medications, dialysis settings, or dietary recommendations based on findings.
5. Patient Education: Provide guidance on managing symptoms, maintaining dialysis access, and lifestyle choices.
6. Follow-up: Schedule next visits and any necessary follow-up tests or consultations.

Duration

Each face-to-face visit typically lasts between 20-40 minutes.

Setting

The procedure is usually performed in outpatient clinics, hospital outpatient departments, or specialized dialysis centers.

Personnel

• Primary Care Physician or Nephrologist
• Nurses specializing in renal care
• Physician assistants or nurse practitioners

Risks and Complications

• Common: Potential for discomfort during physical exams or dialysis access checks.
• Rare: Miscommunication of symptoms leading to delays in treatment modifications.

Benefits

• Improved management of ESRD symptoms.
• Increased effectiveness of dialysis treatment.
• Enhanced quality of life and reduced hospitalizations.

Recovery

• No specific recovery period; patients can typically resume normal activities immediately.
• Follow any specific instructions given by healthcare professionals regarding medications or diet.
• Schedule follow-up visits as recommended.

Alternatives

• Less frequent visits, though this may impact the effectiveness of symptom management and treatment adjustments.
• Telemedicine consultations, which may not provide as comprehensive an assessment as face-to-face visits.

Patient Experience

Patients may feel reassured and supported through regular monitoring and adjustment of their treatment plans. Discomfort may be minimal, and prompt attention to any complications typically enhances their overall sense of well-being. Pain management and comfort measures are addressed as needed during visits.