Renal Disease
Renal Disease
Patients will be considered to be in the terminal stage of renal disease if they meet the following criteria: 1 and either 2 or 3 should be present; factors from 4 will lend supporting documentation.
- The patient is not seeking dialysis or renal transplant or is discontinuing dialysis.
- Creatinine clearance < 10 cc/min (< 15 cc/min. for diabetics) based on measurement or calculation; or < 15 cc/min (< 20cc/min for diabetics) with comorbidity of congestive heart failure.
- Serum creatinine > 8.0 mg/dl (> 6.0 mg/dl for diabetics).
- Signs and symptoms of Acute Renal Failure:
- • 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
- Signs and symptoms of Chronic Renal Failure:
- • Uremia
- • Oliguria (< 400 cc/24 hours)
- • Intractable hyperkalemia (>7.0) not responsive to treatment
- • Uremic pericarditis
- • Hepatorenal syndrome
- • Intractable fluid overload, not responsive to treatment