Uremic symptoms Increasing weakness Bedbound majority of day Creatinine clearance < 10 mL/min Karnofsky Performance Status (KPS) <50% Frequent ED visits EF ≤ 20% Dependence in ≥ 3 ADLs Life expectancy ≤ 6 months Minimal verbal communication Functional decline Multiple pressure ulcers (stage 3-4) Dyspnea at rest or minimal exertion Patient/family chooses comfort care Albumin < 3.1 OR BMI < 18 Incontinence of bowel & bladder Requires assistance with bathing FEV1< 30 PO2<55 O2 Sat <88 INR >1.5 PT > 5 sec multiple comorbid conditions Frequent falls Decline in appetite Unintentional weight loss Poor response to treatment Frequent exacerbations requires continuous oxygen therapy Refractory ascites PPS < 50% O2 dependent Not pursuing dialysis Frequent hospitalizations Non- ambulatory FAST Stage 7C or beyond Oliguria, urine output <400ml / 24hrs advanced age (>95) ECOG score ≥ 3 Progressive disease despite therapy Complications like aspiration pneumonia CD4+ count <25 cell/mm3 or viral load >100k Metastatic disease 2 physicians certify eligibility NYHA Class IV Intractable angina Recurrent infections Uremic symptoms Increasing weakness Bedbound majority of day Creatinine clearance < 10 mL/min Karnofsky Performance Status (KPS) <50% Frequent ED visits EF ≤ 20% Dependence in ≥ 3 ADLs Life expectancy ≤ 6 months Minimal verbal communication Functional decline Multiple pressure ulcers (stage 3-4) Dyspnea at rest or minimal exertion Patient/family chooses comfort care Albumin < 3.1 OR BMI < 18 Incontinence of bowel & bladder Requires assistance with bathing FEV1< 30 PO2<55 O2 Sat <88 INR >1.5 PT > 5 sec multiple comorbid conditions Frequent falls Decline in appetite Unintentional weight loss Poor response to treatment Frequent exacerbations requires continuous oxygen therapy Refractory ascites PPS < 50% O2 dependent Not pursuing dialysis Frequent hospitalizations Non- ambulatory FAST Stage 7C or beyond Oliguria, urine output <400ml / 24hrs advanced age (>95) ECOG score ≥ 3 Progressive disease despite therapy Complications like aspiration pneumonia CD4+ count <25 cell/mm3 or viral load >100k Metastatic disease 2 physicians certify eligibility NYHA Class IV Intractable angina Recurrent infections
(Print)
Uremic symptoms
Increasing weakness
Bedbound majority of day
Creatinine clearance < 10 mL/min
Karnofsky Performance Status (KPS) <50%
Frequent ED visits
EF ≤ 20%
Dependence in ≥ 3 ADLs
Life expectancy ≤ 6 months
Minimal verbal communication
Functional decline
Multiple pressure ulcers (stage 3-4)
Dyspnea at rest or minimal exertion
Patient/family chooses comfort care
Albumin < 3.1 OR BMI < 18
Incontinence of bowel & bladder
Requires assistance with bathing
FEV1< 30 PO2<55 O2 Sat <88
INR >1.5 PT > 5 sec
multiple comorbid conditions
Frequent falls
Decline in appetite
Unintentional weight loss
Poor response to treatment
Frequent exacerbations
requires continuous oxygen therapy
Refractory ascites
PPS < 50%
O2 dependent
Not pursuing dialysis
Frequent hospitalizations
Non-ambulatory
FAST Stage 7C or beyond
Oliguria, urine output <400ml / 24hrs
advanced age (>95)
ECOG score ≥ 3
Progressive disease despite therapy
Complications like aspiration pneumonia
CD4+ count <25 cell/mm3 or viral load >100k
Metastatic disease
2 physicians certify eligibility
NYHA Class IV
Intractable angina
Recurrent infections
