Resources / Hospice for Kidney Failure

Hospice for Kidney Failure

Dr. Andrew Mayo

Chief Medical Officer


October 18, 2023

Kidney failure, often referred to as renal disease, is a medical condition marked by the kidneys’ inability to filter waste products from the blood adequately. When kidney disease progresses to a severe stage, it’s classified as End-Stage Renal Disease (ESRD). At this juncture, the disease may advance to a point where hospice care becomes a crucial part of managing the patient’s health and well-being.

What are the Signs and Symptoms of End-Stage Kidney Failure?

End-stage kidney failure represents a severe state of renal disease where the kidney function has deteriorated to less than 10-15% of normal capacity. The kidneys’ inability to filter waste and excess fluid at this stage manifests in various physical and psychological symptoms affecting the patient’s quality of life. The accumulation of toxins and excess fluid in the body can lead to a myriad of discomforts and medical complications. It’s crucial for patients and their families to recognize the signs and symptoms of end-stage kidney failure to seek timely medical intervention and consider hospice care for better management and comfort. Some of the prevalent signs and symptoms include:

  • Pain
  • Fatigue
  • Water retention/swelling of legs and feet
  • Passing very little or no urine
  • Confusion
  • Loss of appetite
  • Nausea and vomiting
  • Itching
  • Difficulty breathing
  • Difficulty sleeping
  • Anxiety
  • Depression

What are the Hospice Eligibility Criteria for Kidney Failure?

Eligibility for hospice care in kidney failure cases often hinges on several criteria:

  • Ineligibility for dialysis or a kidney transplant.
  • A creatinine clearance level of 8.0 mg/dl or higher without diabetes or 6.0 mg/dl or higher with co-occurring diabetes.
  • Serum creatinine clearance of 8.0 mg/dl or higher without diabetes or 6.0 mg/dl or higher with co-occurring diabetes.
  • Being older than 60 with co-occurring conditions like heart disease, chronic lung disease, malignant cancer, chronic obstructive pulmonary disease, or advanced liver disease.

How Hospice Can Help Families of Those with Kidney Failure

Hospice care extends beyond the patient, offering invaluable support to families, loved ones and caregivers through:

  • Education and tools to manage the patient’s condition.
  • Respite care, allowing families and caregivers a break.
  • Emotional and spiritual support through counseling.
  • Bereavement services to help cope with loss.

How Hospice Can Help Patients with Kidney Failure

Hospice care is a holistic approach aimed at providing comfort and support to patients with life-limiting illnesses like kidney failure. Here’s how hospice care can be beneficial:


The care team educates patients and families about the disease process, what to expect, how to manage symptoms and reduce anxiety and uncertainty.

Proactive Symptom Management

Proactive symptom management and timely interventions can reduce unnecessary hospitalizations.

Emotional Support

Hospice care supports both patients and families, helping them cope with the challenges and emotions associated with a terminal diagnosis.

Personal Care

Hospice aides can assist with daily activities like bathing, dressing and mobility, to manage personal hygiene and support with dignity.

Hospice care can significantly reduce the need for frequent hospital visits, which can be exhausting for both the patient and their family. For instance, St. Croix Hospice provides a range of services tailored to the needs of kidney failure patients, ensuring they receive the highest level of care.

Frequently Asked Questions

How long can you live with end-stage kidney failure?

The life expectancy of an individual with end-stage kidney failure varies greatly, but without dialysis, it can range from a few days to weeks.

Can a person continue dialysis while receiving hospice care?

Typically no, as Medicare often does not cover both dialysis and hospice care for terminal kidney failure patients.

Where can hospice care for kidney failure be provided (e.g., at home, in a hospice facility)?

St. Croix Hospice provides end-of-life care wherever a patient calls home.

How is pain and symptom management handled in hospice care for kidney failure?

Through hospice care practices, addressing symptoms like pain, fatigue and nausea to improve the patient’s quality of life.