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Renal Disease

A patient has:

  • Acute Renal Failure or
  • Chronic Renal Failure (ESRD) and
  • The patient is not undergoing dialysis and
  • Creatinine clearance < 10 cc/min (< 15 cc/min for diabetics) or
  • Serum creatinine > 8.0 mg/dl (> 6.0 mg/dl for diabetics)
    Supporting documentation:
  • Mechanical ventilation
  • Malignancy (other organ system)
  • Chronic lung disease
  • Advanced cardiac disease
  • Advanced liver disease
  • Sepsis
  • Immunosuppression/AIDS
  • Albumin < 3.5 gm/dl
  • Cachexia
  • Platelet count < 25,000
  • Disseminated intravascular coagulation
  • Gastrointestinal bleeding
  • Uremia
  • Oligura (<400 cc/day)
  • Intractable hyperkalemia (>7.0) not responsive to treatment
  • Uremic pericarditis
  • Hepatorenal syndrome
  • Intractable fluid overload

A physician may determine that a patient has a life expectancy of six months or less even if the above findings are not present. Co-morbidities also support eligibility for hospice care.