Renal Disease – For Physicians
To qualify for hospice, patients must have acute or chronic renal failure evidenced by:
Acute renal failure
- Creatinine clearance < 10cc/min
- Serum creatinine > 8.0 mg/dl
- Patients not seeking dialysis or renal transplant
The following symptoms and comorbid conditions will support a hospice referral:
- Comorbid conditions:
- Vascular disease: CHD, PVD, Vascular Dementia, Mechanical ventilation, Malignancy, Chronic lung disease, advanced cardiac disease
- Immunosuppression/AIDS
- Cachexia
- Platelet count < 25,000
- Albumin < 3.5 gm/dl
- Disseminated intravascular coagulation
- Gastrointestinal bleeding
- Advanced liver disease
- Sepsis
Chronic renal failure:
- Creatinine clearance < 10cc/min (<15cc/min for diabetics)
- Serum creatinine > 8.0 mg/dl (> 6.0 mg/dl for diabetics)
- Patients not seeking dialysis or renal transplant
The following are signs and symptoms of chronic renal failure that will lend supporting documentation:
- Uremia
- Uremic pericarditis
- Oliguria
- Intractable hyperkalemia
- Hepatorenal syndrome
- Intractable fluid overload
- Hyperparathyroidism