What are indications for dialysis?

Dialysis is indicated in several clinical scenarios where the kidneys are unable to maintain homeostasis. The options related to acidosis, electrolyte disturbances, fluid overload, uremia, and hypertension each play a role in the decision to initiate dialysis.

Acidosis and electrolyte disorders are significant because the kidneys normally regulate acid-base balance and electrolyte levels like potassium and sodium. When the kidneys fail, metabolic acidosis can occur as the body can’t excrete acid effectively, and electrolyte imbalances can lead to potentially life-threatening conditions, such as hyperkalemia, where elevated potassium levels can cause cardiac issues.

Fluid overload occurs when the kidneys cannot excrete enough fluids, leading to symptoms such as pulmonary edema or heart failure. Uremic complications include symptoms that arise from the accumulation of waste products in the blood due to renal failure, which can manifest as fatigue, anorexia, nausea, and confusion.

Hence, the inclusion of both acidosis or electrolyte imbalances and fluid overload or uremic complications together captures a broad spectrum of critical indications for dialysis, making the combined choice the most comprehensive and accurate. Uncontrolled hypertension can be a consequence of renal failure and often necessitates treatment, but it is typically not a standalone indication for dialysis.