End Stage Renal Disease (ESRD)

ESRD Guidelines

• Clinical Practice Guideline on Shared Decision Making in the Appropriate Initiation of and Withdrawal from Dialysis, 2nd Edition
  RPA’s revised clinical practice guideline provides 19 new and revised recommendations for initiating, withholding and withdrawing dialysis in adult and pediatric patients with AKI, CKD, or ESRD. The revision includes the following new and expanded topic area: establishing a shared decision-making relationship with patients, deciding to initiate or discontinue dialysis, resolving conflicts regarding dialysis, and estimating patient-specific prognoses.
  • Download the Recommendations Summary 
  • Download the Toolkit Section of the Shared Decision-Making Guideline
  • View the AARP Inside E Street video, Dialysis Dilemma  
    

• Clinical Practice Guideline on Adequacy of Hemodialysis
  Why has the trend for dialysis survival become unfavorable in the U.S.? What is an adequate quantity of dialysis? What is the optimum level? The RPA addresses these questions and others in its first Clinical Practice Guideline on Adequacy of Hemodialysis.
   
  
• KDIGO Guideline for the Care of the Kidney Transplant  Recipient 
  The 2009 Kidney Disease: Improving Global Outcomes (KDIGO) clinical practice guideline on the monitoring, management, and treatment of kidney transplant recipients is intended to assist the practitioner caring for adults and children after kidney transplantation.
  
  

Position Papers on ESRD

• Commercial Payers
• Coverage for Dialysis Laboratory Tests
• Coverage for Daily Hemodialysis
• Coverage for Emerging Technologies
• Daily Dialysis
• Dialysis Facility Medical Director Responsibilities Under the Revised CMS Conditions for Coverage for End-Stage Renal Disease Faciliites
• Description of Services under the Monthly Capitation Payment (MCP)
• ESRD Patient Protections
• ESRD Payment System
• Frequency of Hemodialysis in Outpatients
• Guidance on the Proposed CMS ESRD Disease Management Demonstration Project
• Hypertension as a Core Indicator for ESRD
• Improving Accreditation of Dialysis
• Laboratory Tests in Chronic Hemodialysis Patients
• Legislative Issues Related to Linking Reimbursement to Performance Measures in ESRD Care (Part 1 of 3)
• Medical Director Agreements for Nephrologists
• Medicare Coverage of Investigational Devices, Items or Services Used in the Provision of Dialysis
• Medicaid ESRD Structure and Scope of Services Under Managed Care
• Minimal Frequency for Direct Nephrologist/ESRD-Dialysis Patient Contact
• Nephrologist Competency in Extracorporeal Therapies
• Principles on ESRD Patient Participation in Managed Care
• Recommendations for Evaluating Systems Linking Reimbursement to Performance Measures in ESRD Care (Part 3 of 3)
• Regulatory Components of Linking Reimbursement to Performance Measures in ESRD Care (Part 2 of 3)
• Use of Disease Management in ESRD Care

Clinical Performance Measures on ESRD

Clinical Performance Measures on ESRD and Diabetes
The table below includes measures directly relevant to nephrology providers and are intended only for claims-based reporting options. Two ESRD PQRI measures, hemodialysis adequacy plan of care (measure #81) and peritoneal dialysis adequacy plan of care (measure #82) may only be reported through qualified registries.