RENAL DISEASE (1
and 2 OR 3 should be present):
1.
Pt. not seeking
dialysis or renal transplant
2.
Creatinine
clearance <10 cc/min (<15 cc/min for diabetics) OR 15 cc/min (<20 cc/min for
diabetics) with comorbidity of CHF
3.
Serum creatinine
>8.0 mg/dl (>6.0 for diabetics)
Supporting
documentation (for ACUTE):
1.
Mechanical ventilation
2.
GI bleeding
3.
Malignancy in other organ systems
4.
Chronic lung disease
5.
Advanced cardiac disease
6.
Advanced liver disease
7.
Sepsis
8.
AIDS
9.
Albumin < 3.5 gm/dl
10.
Cachexia
11.
Platelet count <25,000
12.Disseminated
intravascular coagulation
Supporting
documentation (for CHRONIC):
1.
Uremia
2.
Intractable hyperkalemia
3.
Uremic pericarditis
4.
Intractable fluid overload, not responsive to tx.
5.
Hepatorenal syndrome
6.
Oliguria (<400 cc/ 24 hrs.)
If you have any
questions please call
Grace Hospice
of