Question

A 58-year-old woman with stage 5 chronic kidney disease develops refractory hyperkalaemia, severe metabolic acidosis and pulmonary oedema despite optimal medical therapy. According to standard indications, what is the most appropriate next step?

Accepted Answer

Urgent renal replacement therapy (dialysis)

Answer

Increase oral bicarbonate only

Answer

Restrict fluid intake and observe

Answer

Start high-dose ACE inhibitor

Answer

No further treatment is required

Practice question

A 58-year-old woman with stage 5 chronic kidney disease develops refractory hyperkalaemia, severe metabolic acidosis and pulmonary oedema despite optimal medical therapy. According to standard indications, what is the most appropriate next step?