Dependence on Renal Dialysis (ICD Z99.2)

Name of the Condition

• Commonly referred to as "Dependence on renal dialysis" or simply "Dialysis dependence."

Summary

Renal dialysis is a life-sustaining treatment for those whose kidneys no longer function properly. People with dependence on renal dialysis require regular sessions to filter waste and excess water from the blood, mimicking the function of healthy kidneys.

Causes

The primary cause of dependence on renal dialysis is end-stage kidney disease (ESKD), which is the result of chronic kidney disease (CKD). Conditions that often lead to CKD include diabetes, high blood pressure, and other chronic conditions affecting kidney function.

Risk Factors

• Chronic diseases like diabetes and hypertension
• Family history of kidney disease
• Age (older adults are at higher risk)
• Certain genetic disorder

Symptoms

Symptoms of needing dialysis include:

• Fatigue
• Swelling, particularly in the lower limbs
• Nausea
• Shortness of breath
• Changes in urination patterns

Diagnosis

Diagnosis involves:

• Blood tests showing elevated levels of creatinine and blood urea nitrogen (BUN)
• Imaging tests to assess kidney structure
• Evaluation by a nephrologist to determine kidney function stages

Treatment Options

The primary treatment is renal dialysis, which includes:

• Hemodialysis: Blood is filtered using a machine
• Peritoneal dialysis: The lining of the abdomen filters the blood internally These treatments are crucial to manage waste buildup in the absence of kidney function.

Prognosis and Follow-Up

• Regular dialysis often results in stabilization of symptoms
• Lifelong treatment unless a kidney transplant is possible
• Regular follow-up appointments are essential to monitor treatment efficacy and manage complications

Complications

• Cardiovascular disease
• Anemia
• Infections, especially related to dialysis access sites
• Electrolyte imbalances

Lifestyle & Prevention

• Adhering to a kidney-friendly diet low in sodium and protein
• Avoiding smoking and excessive alcohol
• Regular exercise to maintain general health

When to Seek Professional Help

Seek immediate medical help if experiencing:

• Severe difficulty breathing
• Unmanageable swelling
• Symptoms of infection, such as fever or drainage at the dialysis site

Additional Resources

• National Kidney Foundation (NKF)
• American Association of Kidney Patients (AAKP)

Tips for Medical Coders

• Ensure Z99.2 is used specifically for dependence on renal dialysis.
• Common errors include confusing with codes for acute kidney conditions; confirm chronic versus acute state with clinical documentation.