Chronic kidney disease, stage 4 (severe)
ICD-10 N18.4 is a billable code used to indicate a diagnosis of chronic kidney disease, stage 4 (severe).
Chronic kidney disease (CKD) stage 4 is characterized by a significant reduction in kidney function, with an estimated glomerular filtration rate (eGFR) of 15 to 29 mL/min. Patients at this stage often experience symptoms such as fatigue, fluid retention, and electrolyte imbalances. The kidneys are severely impaired, leading to the accumulation of waste products in the blood, which can result in complications such as anemia, bone disease, and cardiovascular issues. Management typically involves close monitoring, dietary modifications, and preparation for renal replacement therapy, which may include dialysis or kidney transplantation. Patients may also require management of comorbid conditions such as hypertension and diabetes, which can exacerbate kidney damage. The transition to stage 5, or end-stage renal disease (ESRD), is a critical concern, necessitating timely intervention to prevent further deterioration of kidney function.
Detailed documentation of kidney function tests, comorbidities, and treatment plans.
Patients presenting with worsening renal function, requiring dialysis initiation or transplant evaluation.
Ensure accurate staging of CKD and documentation of all relevant lab results.
Regular monitoring of kidney function and management of associated chronic conditions.
Routine follow-up of patients with known CKD, managing hypertension and diabetes.
Document all referrals to specialists and any changes in treatment plans.
Used for patients with CKD stage 4 requiring dialysis.
Document the need for dialysis and any complications.
Nephrology specialists should ensure accurate documentation of dialysis sessions.
CKD stage 4 indicates severe kidney impairment, requiring careful management to prevent progression to end-stage renal disease and potential need for dialysis or transplant.
