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PROMs Dialysis Quality of Life — ESENeph MCQ

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HardHaemodialysisPROMs Dialysis Quality of LifeESENeph

A haemodialysis patient develops recurrent intradialytic hypotension despite an appropriate target-weight review and modest interdialytic gain. Which dialysis modification is most reasonable?

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

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Correct answer: B — Use cooler dialysate and monitor haemodynamic tolerance

The best answer is “Use cooler dialysate and monitor haemodynamic tolerance”. Cooler dialysate can improve haemodynamic tolerance in recurrent intradialytic hypotension after target weight and ultrafiltration drivers have been reviewed. “Raise dialysate temperature to 38.0°C throughout treatment” promotes vasodilation and may worsen hypotension. “Shorten treatment while preserving the prescribed ultrafiltration volume” increases ultrafiltration intensity. “Increase ultrafiltration during the final hour of treatment” concentrates fluid removal when instability is already likely. “Give routine saline throughout each haemodialysis treatment” can worsen sodium loading and interdialytic weight gain without correcting the prescription driver.

Reference: UK Kidney Association haemodialysis guideline: https://guidelines.ukkidney.org/haemodialysis/