Hospice, Inc.

Metropolitan

    
Guide to Eligibility  Diagnoses   Q & A
End - Stage Renal Disease
© 2004 Metropolitan Hospice Inc. All rights reserved

The patient has 1 or 2, with 3, and either 4 or 5.

1.
Acute Renal Failure
OR
2.
AND
3.
The Patient is not undergoing dialysis
AND
4.
Creatinine clearance < 10 cc/min (<15 cc/min for diabetics)
OR
5.
Serum creatine > 8.0 mg/dl (> 6.0 mg/dl for diabetics)
Supportive Evidence:
  • Mechanical ventilation
  • Malignancy (other organ system)
  • Chronic lung disease
  • Advanced cardiac disease
  • Advanced liver disease
  • Sepsis
  • Immunosuppression/AIDS
  • Cachexia
  • Uremia
  • Uremic pericarditis
  • Albumin < 3.5 gm/dl
  • Platelet count <25,000
  • Disseminated intravascular coagulation
  • Gastrointestinal bleeding
  • Oligura (<400 cc/day)
  • Intractable hyperkalemia (> 7.0) not responsive to treatment
  • Hepatorenal syndrome
  • Intractable fluid overload
In the absence of one or more of the above findings, rapid decline or comorbidities may also support eligibility for hospice care.