Fluid and Electrolyte Balance in Dialysis Flashcards

Which parameter is used to determine the ultrafiltration volume goal for a hemodialysis patient?

Answer: Difference between current weight and estimated dry weight

Ultrafiltration volume is calculated as the difference between the patient's current (wet) weight and their estimated dry weight (ideal fluid-free weight).

A dialysis patient's predialysis serum potassium is 6.8 mEq/L. Which dialysate potassium concentration is most appropriate?

Answer: 2.0 mEq/L

A 2.0 mEq/L dialysate potassium provides adequate gradient to remove excess potassium while reducing the risk of arrhythmia from overly rapid shifts.

What is the normal serum phosphorus target range for dialysis patients per KDIGO guidelines?

Answer: 2.5–4.5 mg/dL

KDIGO guidelines recommend lowering elevated serum phosphorus toward the normal range of approximately 2.5–4.5 mg/dL in dialysis patients.

Which fluid restriction guideline is commonly recommended for anuric hemodialysis patients?

Answer: Urine output plus 500–750 mL/day

Non-anuric patients are restricted to their urine output plus 500–750 mL/day to account for insensible losses while preventing interdialytic fluid overload.

Hypermagnesemia in dialysis patients most commonly results from which of the following?

Answer: Regular use of magnesium-containing antacids or laxatives

Dialysis patients who use magnesium-containing antacids or laxatives are at risk for hypermagnesemia because the kidneys cannot excrete excess magnesium.

A dialysis patient presents with a serum calcium of 11.8 mg/dL. Which medication is the most likely culprit?

Answer: Calcium carbonate phosphate binder

Calcium carbonate is a calcium-based phosphate binder that contributes to hypercalcemia when taken in excess or with high-calcium dialysate.