CCHT Interpretation of Common Laboratory Values 2

Question 1

A hemodialysis patient's serum phosphorus is 7.8 mg/dL. Which of the following is the most appropriate dietary recommendation to address this finding?

Accepted Answer

Restrict foods high in phosphorus such as dairy, nuts, and cola drinks

Answer

A serum phosphorus of 7.8 mg/dL is significantly elevated (normal 3.5–5.0 mg/dL for ESRD is targeted at 3.5–5.5 mg/dL). Dietary phosphorus restriction focusing on dairy products, nuts, seeds, and phosphate-additive-containing foods (especially cola drinks) is a primary management strategy alongside phosphate binders.

Question 2

What does a Kt/V value of 1.2 indicate about a hemodialysis patient's treatment adequacy?

Accepted Answer

The patient is receiving the minimum adequate dose of dialysis per current guidelines

Answer

Kt/V of 1.2 meets the minimum KDOQI recommended target for thrice-weekly hemodialysis (minimum 1.2, target ≥1.4). It indicates the patient is receiving an adequate dose of dialysis, though higher values provide additional benefit.

Question 3

Which laboratory value is used to assess long-term glycemic control in a dialysis patient with diabetes?

Accepted Answer

Hemoglobin A1c (HbA1c)

Answer

Hemoglobin A1c (HbA1c) reflects average blood glucose over approximately 2–3 months and is the standard measure of long-term glycemic control. However, in dialysis patients with anemia and frequent transfusions, HbA1c may be falsely low, so fructosamine or glycated albumin may be used as alternatives.

Question 4

A hemodialysis patient's monthly labs show serum potassium of 6.8 mEq/L. What is the most urgent concern?

Accepted Answer

Risk of fatal cardiac arrhythmias

Answer

Hyperkalemia (potassium >6.5 mEq/L) poses an immediate risk of life-threatening cardiac arrhythmias including ventricular fibrillation and asystole. This is the most urgent clinical concern and requires prompt intervention including dietary restriction, dialysate potassium adjustment, and possibly emergency dialysis.

Question 5

What is the target range for serum intact parathyroid hormone (iPTH) in patients on maintenance hemodialysis?

Accepted Answer

150–600 pg/mL (2–9 times the upper limit of normal)

Answer

KDIGO guidelines recommend targeting iPTH levels 2–9 times the upper limit of normal for the assay used, which for most laboratories corresponds to approximately 150–600 pg/mL. This range balances suppression of excessive bone remodeling against the risks of adynamic bone disease from over-suppression.

CCHT - Certified Clinical Hemodialysis Technician Practice Test

CCHT - Certified Clinical Hemodialysis Technician Practice Test

CCHT Interpretation of Common Laboratory Values 2