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Renal Disease

Renal Disease - For Physicians

To qualify for hospice, patients must have acute or chronic renal failure evidenced by:

Acute renal failure

  • Creatinine clearance < 10cc/min
  • Serum creatinine > 8.0 mg/dl
  • Patients not seeking dialysis or renal transplant
The following symptoms and comorbid conditions will support a hospice referral:
  • Comorbid conditions:
    • Vascular disease: CHD, PVD, Vascular Dementia, Mechanical ventilation, Malignancy, Chronic lung disease, advanced cardiac disease
    • Immunosuppression/AIDS
    • Cachexia
    • Platelet count < 25,000
    • Albumin < 3.5 gm/dl
    • Disseminated intravascular coagulation
    • Gastrointestinal bleeding
    • Advanced liver disease
    • Sepsis


Chronic renal failure:
  • Creatinine clearance < 10cc/min (<15cc/min for diabetics)
  • Serum creatinine > 8.0 mg/dl (> 6.0 mg/dl for diabetics)
  • Patients not seeking dialysis or renal transplant

The following are signs and symptoms of chronic renal failure that will lend supporting documentation:

  • Uremia
  • Uremic pericarditis
  • Oliguria
  • Intractable hyperkalemia
  • Hepatorenal syndrome
  • Intractable fluid overload
  • Hyperparathyroidism


Renal Disease - For Families

When is it time for end-stage Renal Disease hospice care?

Answering these questions may serve as a guide:

  • Do you (or a loved one) wish to forgo dialysis?
  • Are you (or your loved one) ready to seek “aggressive comfort care” instead of aggressive treatment?


If you answered “yes” to these questions, now may be an appropriate time to discuss Longleaf Hospice with your physician or one of our clinical professionals. Feel free to call us directly at 770-939-9179.