Renal Disease

Admission Criteria for End Stage Renal Failure (Acute or Chronic)

Patient must meet 1-5:
  • Discontinuing or refusing dialysis
  • Creatinine clearance < 10 cc/min (< 15 cc/min for diabetics)
  • Serum creatinine > 8.0 mg/dl (>6.0 mg/dl for diabetics)
  • Karnofsky score of 6 or less
  • ADL score of 20 or less
  • Descriptive score of 16 or less
  • Supporting documentation
  • Mechanical ventilation
  • Malignancy
  • Chronic Lung Disease
  • Advanced Cardiac Disease
  • Sepsis
  • Immunosupression/AIDS
  • Albumin < 3.5 gm/dl
  • Cachexia
  • Platelet count < 25,000
  • Disseminated intravascular coagulation
  • Gastrointestinal bleeding
  • Uremia
  • Oliguria (<400 cc/day)
  • Intractable hyperkalemia (>7.0)
  • Uremic pericarditis
  • Hepatorenal syndrome
  • Intractable fluid overload
  • Prior increasing visits to ER or prior hospitalizations for pulmonary infections and/or respiratory failure. Documentation of serial decrease of FEV1> 40 ml/year is objective evidence for disease progression.
  • Hypoxemia at rest on room air (pO2 < 55 mmHg or O2 saturation < 88%) or hypercapnia (pCO2 > 5mmHg)
  • Karnofsky score of 50 or less
  • Cor pulmonale and right heart failure (RHF) secondary to pulmonary disease (not secondary to left heart disease or valvulopathy)
  • Unintentional weight loss of > 10% of body weight over preceding 6 months
  • Resting tachycardia > 100/min