Uraemic Symptoms Inadequate Dialysis — ESENeph MCQ

Instant feedback + full explanation. One question, done properly.

EasyHaemodialysisUraemic Symptoms Inadequate DialysisESENeph

A 65-year-old man with CKD G5D on haemodialysis complains of intractable hiccups, nausea, and metallic taste. His recent dialysis has been suboptimal due to repeated access problems. Urea is 52 mmol/L. What do these symptoms represent?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Uraemic symptoms indicating inadequate dialysis

Intractable hiccups, nausea, anorexia, metallic taste, and fatigue are classic uraemic symptoms indicating inadequate solute clearance. Elevated urea (52 mmol/L pre-dialysis, likely reflecting poor dialysis delivery) supports this. Management involves optimising dialysis delivery – addressing access problems, ensuring adequate session duration and blood flow rates, and checking spKt/V. If access cannot be salvaged, new access should be created urgently. Temporary catheter placement may bridge the gap.

Reference: KDOQI 2015 – HD Adequacy; UKKA 2019 – HD Guideline