End-Stage Renal Disease:
Guidelines for End-Stage Renal Disease & Related Disorders

LIFE-LIMITING CONDITION AS EVIDENCED BY:

• Creatinine Clearance < 10cc/min. • Serum creatinine > 8.0 md/dL (15cc/ for diabetics).
• Estimated glomerular filtration rate (GFR) < 10 ml/min.
• Serum creatinine > 8.0 md/dL (6.0 mg/dL for diabetics).

SECONDARY CONDITIONS:

• Fluid overload, dyspnea.
• Mechanical ventilation.
• Electrolyte abnormalities.
• Advanced CHF.
• Immunosuppression/AIDS.
• Platelet count < 25,000.
• Uremia.
• Uremic pericarditis.
• Oliguria < 400cc/ 24 hours.
• Hypoalbuminemia.
• Malignancy.
• Chronic lung disease.
• Advanced liver disease.
• Albumin < 3.5 gm/dL.
• Intractable fluid overload.
• Hyperkalemia.
• Hepatorenal syndrome.
• GI bleeding.

HOW WE HELP — END-STAGE RENAL DISEASE:

• Emotional and spiritual support.
• Management of pain and symptom relief.
• Education regarding progression of decline post dialysis cessation.
• Comfort care for congestion, restlessness, mental changes.
• Emotional support for family as disease progresses.
• Spiritual support for family and patient.