Name of the Procedure:

Dialysis Treatment for End-Stage Renal Disease (ESRD) Less Than a Full Month of Service, Per Day; Patients 12-19 Years of Age

Summary

This treatment involves daily dialysis sessions for young patients aged 12-19 with end-stage renal disease (ESRD) for periods of less than a full month. Dialysis helps to perform the kidney's function of filtering waste and excess fluids from the blood when the kidneys are no longer able to do so.

Purpose

• Medical Condition: End-stage renal disease (ESRD)
• Goals/Outcomes: To remove waste products and excess fluid from the blood, manage electrolyte imbalance, and maintain overall health until a more permanent solution (such as kidney transplant) is available.

Indications

• ESRD diagnosed in patients aged 12-19
• Severe kidney function impairment where kidneys can no longer filter blood effectively
• Symptoms like fatigue, swelling, nausea, and difficulty breathing due to kidney failure

Preparation

• Pre-Procedure Instructions: Follow a specific dietary plan, possibly adjust medications, and stay hydrated.
• Diagnostic Tests: Blood tests to determine electrolyte levels, kidney function tests, and a thorough medical history.

Procedure Description

1. Access Point: A catheter is usually inserted into a vein or an existing dialysis access point is used.
2. Dialysis Machine Setup: The dialysis machine and dialyzer (artificial kidney) are prepared and connected to the patient.
3. Blood Filtration: Blood is drawn from the body, filtered through the dialyzer, and then returned to the body.
4. Fluid Control: Any excess fluids are removed to maintain a healthy fluid balance.
   • Tools/Equipment: Dialysis machine, dialyzer, sterile catheters or fistulas.
   • Anesthesia/Sedation: Typically, no anesthesia is required unless inserting a new catheter.

Duration

Each dialysis session usually lasts 3 to 4 hours. The duration can vary based on the patient's specific condition and response.

Setting

Dialysis is performed in a hospital dialysis unit or outpatient dialysis clinic.

Personnel

• Nephrologist (kidney specialist)
• Dialysis nurse or technician
• Support staff specialized in pediatric care

Risks and Complications

• Common Risks: Low blood pressure, muscle cramps, and dehydration.
• Rare Risks: Access point infections, blood clots, or severe allergic reactions to dialysis materials.
• Management: Close monitoring during sessions and immediate medical intervention if complications arise.

Benefits

• Effective removal of waste and excess fluids
• Improved overall health and symptom management
• Stabilized blood pressure and electrolyte levels
• Benefits usually observed almost immediately after each session.

Recovery

• Post-Procedure Care: Maintain a healthy diet, monitor fluid intake, and follow prescribed medications.
• Recovery Time: Patients may feel tired after sessions but can generally resume normal activities within a few hours.
• Follow-Up: Regular follow-up appointments for ongoing assessment and adjustments as needed.

Alternatives

• Kidney Transplant: A more permanent solution but requires a matching donor and is subject to waiting lists and immunosuppressive medication.
• Conservative Management: Symptom control without dialysis, focusing on quality of life and comfort, typically for patients not opting for intensive treatments.

Patient Experience

• During the Procedure: Patients might feel a slight prick when accessing veins, some discomfort from sitting for long periods, and potential dizziness or fatigue.
• After the Procedure: Temporary tiredness or soreness at the access site. Pain management and comfort measures include staying well-hydrated and resting post-treatment.