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End-stage renal disease (ESRD) related services for dialysis less than a full month of service, per day; for patients 12-19 years of age
CPT4 code
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
- Access Point: A catheter is usually inserted into a vein or an existing dialysis access point is used.
- Dialysis Machine Setup: The dialysis machine and dialyzer (artificial kidney) are prepared and connected to the patient.
- Blood Filtration: Blood is drawn from the body, filtered through the dialyzer, and then returned to the body.
- 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.