1. chronic kidney disease kdigo stage 4, 5, or 5d. 2. next of kin unwilling or patient unwilling to participate. 3. patients with a life expectancy of fewer than 72 hours according to the attending physician criteria. 4. patients older than 75 years. 5. patients with sofa \> 11. 6. patients with severe liver failure.

1. chronic kidney disease kdigo stage 4, 5, or 5d. 2. next of kin unwilling or patient unwilling to participate. 3. patients with a life expectancy of fewer than 72 hours according to the attending physician criteria. 4. patients older than 75 years. 5. patients with sofa \> 11. 6. patients with severe liver failure.

chronic kidney disease kdigo stage 4, 5, or 5d. next of kin unwilling or patient unwilling to participate. patients with a life expectancy of fewer than 72 hours according to the attending physician criteria. patients older than 75 years. patients with sofa > 11. patients with severe liver failure.

chronic kidney disease kdigo stage 4, 5, or 5d. next of kin unwilling or patient unwilling to participate. patients with a life expectancy of fewer than 72 hours according to the attending physician criteria. patients older than 75 years. patients with sofa > 11. patients with severe liver failure.

1. chronic kidney disease kdigo stage 4, 5, or 5d. 2. next of kin unwilling or patient unwilling to participate. 3. patients with a life expectancy of fewer than 72 hours according to the attending physician criteria. 4. patients older than 75 years. 5. patients with sofa > 11. 6. patients with severe liver failure.

1. chronic kidney disease kdigo stage 4, 5, or 5d. 2. next of kin unwilling or patient unwilling to participate. 3. patients with a life expectancy of fewer than 72 hours according to the attending physician criteria. 4. patients older than 75 years. 5. patients with sofa > 11. 6. patients with severe liver failure.