Fluid and Electrolyte Balance in Dialysis Flashcards

Which acid-base disorder is most commonly observed in patients with end-stage renal disease prior to dialysis?

Answer: Metabolic acidosis

Failed kidneys cannot excrete fixed acids or regenerate bicarbonate, leading to chronic metabolic acidosis in ESRD patients.

What interdialytic weight gain is generally considered the maximum acceptable limit for a hemodialysis patient?

Answer: 3–5% of dry body weight

Interdialytic weight gain up to 3–5% of dry body weight is generally considered acceptable, though lower gains are associated with better outcomes.

Which sign/symptom is associated with hyponatremia in a dialysis patient?

Answer: Confusion, seizures, and muscle weakness

Severe or rapidly developing hyponatremia causes neurological symptoms including confusion, seizures, and weakness due to cerebral edema.

A dialysis patient develops peaked T-waves and widened QRS on ECG. Which electrolyte abnormality is most likely responsible?

Answer: Hyperkalemia

Hyperkalemia produces sequential ECG changes including peaked T-waves, PR prolongation, widened QRS, and ultimately sine-wave pattern with cardiac arrest.

What role does aluminum toxicity play in dialysis patients?

Answer: Leads to adynamic bone disease and encephalopathy

Aluminum accumulation in dialysis patients, historically from aluminum-containing phosphate binders and contaminated water, causes adynamic bone disease, anemia, and encephalopathy.

Which dietary restriction is most important for ESRD patients between hemodialysis sessions to prevent life-threatening complications?

Answer: Restrict potassium and phosphorus intake

Limiting potassium prevents fatal hyperkalemia and limiting phosphorus prevents secondary hyperparathyroidism and vascular calcification between dialysis sessions.