N18.6
End stage renal disease
Clinical Classification Guidelines
Use Additional Code
- code to identify dialysis status (Z99.2)
Inclusion Terms
- Chronic kidney disease requiring chronic dialysis
Medical Intelligence & Overview
End Stage Renal Disease (ESRD), classified under ICD-10 code N18.6, is the final phase of chronic kidney disease (CKD). It occurs when the kidneys are no longer able to perform their essential functions effectively, necessitating dialysis or kidney transplantation. This condition profoundly impacts overall health, as the kidneys play a crucial role in filtering waste, balancing fluids and electrolytes, and regulating blood pressure. ESRD typically develops over several years, often following progressive deterioration of kidney function, and requires ongoing medical management to sustain life.
Causes & Symptoms
Clinical Causes: Diabetes mellitus, especially poorly controlled Chronic hypertension (high blood pressure) Glomerulonephritis (inflammation of the kidney's filtering units) Polycystic kidney disease (a genetic disorder) Prolonged obstruction of the urinary tract Chronic use of nephrotoxic medications Other systemic diseases affecting the kidneys
Key Symptoms: Fatigue and weakness Swelling in legs, ankles, or feet Shortness of breath Persistent nausea or vomiting Loss of appetite Changes in urine output, including decreased or foamy urine Muscle cramps Confusion or difficulty concentrating High blood pressure that is difficult to control
Diagnostic & Treatment
Diagnosis Path: Blood tests to measure levels of waste products like creatinine and urea, and to assess electrolyte balance Estimated Glomerular Filtration Rate (eGFR) to evaluate kidney function Urinalysis to detect protein or blood in the urine Imaging tests such as ultrasound to examine kidney structure Assessment of symptoms and medical history
Treatment Protocols: Dialysis (hemodialysis or peritoneal dialysis) to remove waste products and excess fluid Kidney transplantation as a potential curative option Medications to control blood pressure, manage anemia, and prevent mineral imbalances Dietary modifications to reduce strain on the kidneys, such as limiting salt, phosphorus, and protein intake Regular monitoring of blood and urine tests to track disease progression
Clinical Advice & FAQs
Billing Guidance
Is N18.6 a billable ICD-10 code?
Yes, N18.6 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.
Documentation
How do I report N18.6?
Clinical documentation must specify the nature of End stage renal disease and any associated comorbidities for accurate reporting.
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