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Comorbid Conditions Making Chronic Dialysis Futile

Purpose: To determine if a patient has one or more comorbid conditions that may make chronic dialysis futile.

Description

A patient with end-stage renal disease may have one or more comorbid conditions that make chronic dialysis a futile and expensive process. A patient or family of a patient with one or more of these conditions should consider refusing chronic dialysis.


 

Conditions associated with little if any benefit from a chronic dialysis program:

(1) irreversible dementia not due to uremia

(2) severe irreversible neurologic disorder (stroke, encephalopathy, other) associated with ECOG performance status 4 (confined to bed or chair and dependent in activities of daily living) or coma

(3) metastatic or unresectable solid malignancy refractory to therapy

(4) progressive hematologic malignancy refractory to therapy

(5) end-stage organ failure involving liver, lung, and/or heart, with ECOG performance status 4 (confined to bed or chair and dependent in activities of daily living)

(6) irreversible multi-organ failures with poor prognosis

(7) need to restrain and/or sedate patient during each dialysis session

 


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Specialty

Objective

ICD-10