End-Stage Renal Disease

End-Stage Renal Disease

End-Stage Renal Disease (ESRD) is associated with impairments, activity limitations and disability with the identification of specific structural/functional impairments and any relevant activity limitations.
Ultimately, in order to support a hospice plan of care, the combined effects of ESRD and any identified secondary condition(s) and/or co-morbidities should be such that most beneficiaries with the identified impairments
would have a prognosis of six months or less.
Secondary and co-morbid condition(s) themselves may be associated with a new set of structural/functional impairments that may or may not respond/be amenable to treatment.

1. ESRD complicated by co-morbid conditions such as:
a. Coronary Artery Disease
b. Peripheral Vascular Disease
c. Vascular Disease

2. Oliguria
a. Urine output less than 400cc/24 hr

3. Uremia (clinical symptoms of renal failure)
a. Confusion
b. Nausea/vomiting
c. Generalized Pruritus
d. Restlessness

4. Fluid overload

5. Creatinine Clearance or <10cc/min or 15cc/min
with diabetes

6. Serum Creatinine > 8.0mg/dl or 6.0mg/dl with diabetes

7. Dialysis burdens outweigh benefits