The patient has 1 and either 2 or 3.
1.
The
patient is not seeking dialysis transplant
AND
2.
Creatine
clearance* <10cc/min (<15cc/min for diabetics)
OR
3.
Serum
creatine > 8.0mg/dl (> 6.0 mg/dl for diabetics)
Supportive
Evidence:
- Uremia
- Oliguria
(urine output is less than 400 cc in 24 hours)
- Intractable
hyperkalemia (greater than 7.0) not responsive to
treatment
- Uremic
pericarditis
- Hepatorenal
syndrome
- Immunosuppression/AIDS
- Intractable
fluid overload, not responsive to treatment
*Creatine
Clearance Calculation
- (140-age)
x (weight) ÷ 72 x (serum creatine in mg/dl)
multiply by 0.85 for women
- Age
in years
- Weight
in Kg
In the absence of one or more of the above findings,
rapid decline or comorbidities may also support eligibility for hospice
care.
