Renal Disease Patients will be considered to be in the terminal stage of renal disease if they meet the following criteria: Acute renal failure (1, 2 AND 3 must be present; factors from 4 will lend supporting documentation): 1. The patient is not seeking dialysis or renal transplant.
AND

2.Creatinine clearance <10 cc/min (<15 cc/min. for diabetes)
AND

3. Serum creatinine > 8.0 mg/dl (>6.0 mg/dl for diabetes) 4. Supporting documentation of comorbidities: a. Mechanical ventilation
b. Malignancy (other organ system)
c. Chronic lung disease
d. Advanced cardiac disease
e. Advanced liver disease
f. Sepsis
g. Immunosuppression/AIDS
h. Albumin <3.5 gm/d
i. Cachexia
j. Platelet count <25,000
k. Disseminated intravascular coagulation
l. Gastrointestinal bleeding
Chronic Renal Failure (1, 2, and 3 must be present; factors from 4 will lend supporting documentation): 1. The patient is not seeking dialysis or renal transplant.
AND

2.Creatinine clearance <10 cc/min (<15 cc/min. for diabetes)
AND

3. Serum creatinine > 8.0 mg/dl (>6.0 mg/dl for diabetes) 4. Supporting documentation of comorbidities: a. Uremia
b. Urine output < 400 cc/day
c. Intractable hyperkalemia (> 7.0) not responsive to treatment
d. Uremic pericarditis
e. Hepatorenal syndrome
f. Intractable fluid overload, not responsive to treatment
If a patient meets the medical criteria above, they are by definition eligible to receive hospice services. Some patients may not meet the criteria, but may still be eligible for hospice care due to comorbidities or rapid functional decline. Contact your Samaritan Care Hospice Consultant for further information.