Injection, Argatroban, 1 mg (For ESRD on Dialysis) (J0884)

Name of the Procedure:

Common Names: Argatroban Injection
Technical/Medical Terms: Injection, Argatroban, 1 mg (for End-Stage Renal Disease [ESRD] on Dialysis)

Summary

Argatroban injection is a medication administered to patients undergoing dialysis due to End-Stage Renal Disease (ESRD). It is used to prevent blood clotting during dialysis treatment.

Purpose

Medical Conditions/Problems Addressed:
Argatroban is an anticoagulant, designed to reduce the risk of forming blood clots during dialysis sessions in patients with ESRD.

Goals/Expected Outcomes:
The primary goal is to prevent clot formation in the dialysis circuit, ensuring smooth and effective dialysis sessions.

Indications

Symptoms/Conditions:

• ESRD patients undergoing dialysis
• Risk of clot formation during dialysis

Patient Criteria:

• Confirmed diagnosis of ESRD
• Currently receiving dialysis treatment

Preparation

Pre-procedure Instructions:

• No specific fasting required
• Regular medication should be taken unless otherwise directed by a healthcare provider

Diagnostic Tests/Assessments:

• Blood tests to assess renal function and clotting parameters

Procedure Description

Step-by-Step Explanation:

1. Preparation: The healthcare provider reviews the patient's medical history and recent blood work.
2. Injection: Argatroban is administered intravenously at a dose of 1 mg per kg of body weight per hour during the dialysis session.
3. Monitoring: The patient is closely monitored for any adverse reactions and effectiveness of the anticoagulation.

Tools/Equipment:

• Intravenous (IV) line
• Syringe for medication administration
• Dialysis machine

Anesthesia/Sedation Details:

• Not applicable; no anesthesia or sedation is required.

Duration

Typical Duration:
The procedure typically lasts as long as the dialysis session, which can vary but usually ranges from 3-4 hours.

Setting

Location:

• Hospital dialysis unit
• Outpatient dialysis clinic

Personnel

Healthcare Professionals Involved:

• Nephrologist
• Dialysis nurse
• Pharmacist

Risks and Complications

Common Risks:

• Bleeding at the injection site
• Minor bruising

Rare Risks:

• Severe bleeding
• Allergic reaction to the medication

Management of Complications:

• Immediate medical attention and supportive care for severe reactions

Benefits

Expected Benefits:

• Prevention of clot formation during dialysis
• Improved dialysis efficiency

Time to Realize Benefits:

• Immediate effect during the dialysis session

Recovery

Post-Procedure Care:

• Monitoring of clotting parameters post-dialysis
• Routine dialysis follow-up care

Expected Recovery Time:

• No extended recovery time needed; normal activities can typically be resumed post-dialysis

Restrictions/Follow-up:

• Regular follow-up appointments with nephrologist
• Routine blood tests to monitor renal function and medication effect

Alternatives

Other Treatment Options:

• Use of other anticoagulants such as heparin

Pros and Cons of Alternatives:

• Heparin is also effective but may have different side effect profiles and interactions

Patient Experience

During the Procedure:

• Minimal discomfort from the injection
• Close monitoring by healthcare staff

After the Procedure:

• Typically no significant pain or discomfort
• Regular activities can usually be resumed immediately after

Pain Management and Comfort Measures:

• Comfort measures during dialysis
• Immediate attention to any side effects or discomfort