End-stage renal disease (ESRD) related services for home dialysis per full month, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents
CPT4 code
Name of the Procedure:
End-Stage Renal Disease (ESRD) Related Services for Home Dialysis Per Full Month for Patients Younger Than 2 Years of Age
Summary
This procedure involves the monthly management and support of infants and toddlers under the age of 2 who require home dialysis due to end-stage renal disease. It ensures that the child receives adequate nutrition, proper growth and development assessments, and provides essential counseling to parents.
Purpose
The primary purpose of these ESRD related services is to manage the child's chronic kidney failure effectively at home, ensuring their nutritional needs are met, monitoring their growth and development, and providing parents with the knowledge and support necessary to care for their child.
Indications
- Diagnosed with end-stage renal disease.
- Patient is younger than 2 years of age.
- Need for regular dialysis treatment.
- Requirement for continuous nutritional and developmental assessment.
- Parents or guardians capable of managing home dialysis with professional guidance.
Preparation
- No specific fasting or medication adjustments needed.
- Regularly scheduled diagnostic tests: blood work, nutritional assessments, and growth charts.
- Training for parents on home dialysis procedures and equipment setup.
Procedure Description
- Assessment and Monitoring: Monthly evaluations of the child's growth, nutritional intake, and overall development.
- Dialysis Support: Education and guidance on performing home dialysis. Monthly review of dialysis logs and machine checks.
- Parent Counseling: Providing emotional and practical support, answering questions, and offering advice on managing ESRD.
- Coordination: Ensuring coordination with a multidisciplinary team, including dietitians, pediatric nephrologists, and dialysis nurses.
Duration
Each monthly service session can range from 1 to 2 hours, depending on the complexity of the case and family needs.
Setting
These services are primarily provided at the patient's home, although some components may require visits to a healthcare provider’s office.
Personnel
- Pediatric Nephrologist
- Dialysis Nurse
- Dietitian
- Pediatrician
- Social Worker/Counselor
Risks and Complications
- Infections related to dialysis catheters.
- Imbalances in electrolytes.
- Risks associated with improper dialysis technique.
- Potential growth and development delays if not adequately monitored.
Benefits
- Improved quality of life for the child and family.
- Effective management of ESRD symptoms.
- Early detection and correction of nutritional deficits.
- Support for optimal growth and development.
Recovery
- Continuous care approach with no traditional recovery period.
- Ongoing daily care and monitoring by parents with monthly professional intervention.
- Regular follow-ups and 24/7 access to healthcare providers for emergencies.
Alternatives
- In-center hemodialysis (requires frequent visits to a dialysis clinic).
- Kidney transplant (best long-term solution but depends on donor availability).
- Palliative care (for non-aggressive management, focusing on comfort).
Patient Experience
- The child might experience discomfort during dialysis procedures.
- Proper training and support minimize complications and enhance comfort.
- Parents receive comprehensive support, addressing both emotional and practical challenges.
- Pain management strategies include topical anesthetics and distraction techniques during procedures.