Understanding Chronic Kidney Disease Stage 5 (CKD 5), also known as End-Stage Renal Disease (ESRD), is crucial for accurate clinical documentation and medical coding. This resource provides information on CKD stage 5 diagnosis, treatment, and management, including relevant ICD-10 codes, SNOMED CT codes, and clinical terminology for healthcare professionals. Learn about ESRD symptoms, dialysis, kidney transplant options, and palliative care considerations for end-stage renal failure.
Also known as
Chronic kidney disease, stage 5
End-stage renal disease requiring dialysis or transplant.
End stage renal disease
Unspecified end stage renal disease.
Dependence on renal dialysis
Patient requires dialysis for kidney failure.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the patient diagnosed with Chronic Kidney Disease Stage 5?
Yes
Is the patient receiving dialysis?
No
Do NOT code as CKD Stage 5. Review patient record for correct CKD stage or other diagnosis.
When to use each related code
| Description |
|---|
| Complete kidney failure requiring dialysis or transplant. |
| Severely reduced kidney function, nearing kidney failure. |
| Moderately reduced kidney function, often asymptomatic. |
Coding CKD Stage 5 without specifying cause or complications impacts reimbursement and quality reporting.
Failing to code ESRD when CKD Stage 5 is present leads to underreporting severity and missed dialysis claims.
Discrepancies between documented stage and clinical indicators can cause coding errors and compliance issues.
Q: What are the most effective strategies for managing fluid overload in patients with Chronic Kidney Disease Stage 5 (CKD 5) and End-Stage Renal Disease (ESRD)?
A: Fluid overload is a common and serious complication in patients with CKD 5 and ESRD. Effective management strategies include strict sodium and fluid restriction, optimizing ultrafiltration during dialysis (adjusting dialysis time and/or blood flow rate based on patient's dry weight), and prescribing diuretics like furosemide if residual kidney function is present. Careful monitoring of daily weights, blood pressure, and signs of fluid overload (e.g., edema, shortness of breath) is crucial. Consider implementing strategies for patient education regarding fluid management to improve adherence. Explore how combining these approaches can improve patient outcomes and reduce hospitalizations related to fluid overload. Learn more about advanced ultrafiltration techniques for refractory fluid overload.
Q: How can clinicians differentiate between CKD 5 and other causes of acute kidney injury (AKI) when evaluating a patient with rapidly declining kidney function?
A: Differentiating CKD 5 from AKI can be challenging, especially in patients with a prior history of chronic kidney disease. Key indicators for CKD 5 include a history of progressive kidney function decline, presence of small, echogenic kidneys on ultrasound, and evidence of secondary hyperparathyroidism or renal osteodystrophy. AKI, on the other hand, often presents with an abrupt decline in kidney function often triggered by a specific event (e.g., infection, medication nephrotoxicity, hypotension). Careful review of the patient's medical history, laboratory data (including serum creatinine trend, urinalysis, and imaging studies), and assessment for reversible causes of AKI are essential. Consider a kidney biopsy for diagnostic clarification when the etiology remains unclear. Explore the latest guidelines for evaluating and managing AKI to improve diagnostic accuracy.
Patient presents with end-stage renal disease (ESRD), also known as chronic kidney disease stage 5 (CKD 5), confirmed by estimated glomerular filtration rate (eGFR) persistently below 15 mL/min/1.73 m2 and the need for renal replacement therapy. Clinical manifestations include uremia, fluid overload, electrolyte imbalances (hyperkalemia, hyperphosphatemia), and metabolic acidosis. Patient reports fatigue, decreased appetite, nausea, vomiting, pruritus, and sleep disturbances. Physical examination reveals fluid retention, pallor, and signs of malnutrition. Laboratory findings demonstrate elevated creatinine, blood urea nitrogen (BUN), and potassium levels. Diagnosis of CKD stage 5 is consistent with the National Kidney Foundation KDOQI guidelines. Treatment plan includes initiation of hemodialysis, dietary management with protein restriction and phosphorus control, medication management for anemia (erythropoietin stimulating agents), mineral bone disease (phosphate binders, vitamin D analogs), and blood pressure control. Patient education provided regarding dialysis access care, medication adherence, and dietary restrictions. ICD-10 code N18.6, chronic kidney disease stage 5. Referral made to nephrology and dietitian for ongoing care and management. Prognosis discussed with the patient and family, including options for kidney transplant evaluation. Follow-up scheduled in one week to monitor dialysis adequacy and manage potential complications.