Minimum 4-Hour HD Session Adequacy — ESENeph MCQ

Correct answer: D — Address barriers and restore prescribed treatment time and delivered dialysis dose

The best answer is “Address barriers and restore prescribed treatment time and delivered dialysis dose”. UKKA recommends monitoring delivered dose and treatment time. Transport, vascular access, tolerance and scheduling problems should be corrected so the prescribed clearance is actually delivered. “Assess symptoms alongside delivered Kt/V and other measures of dialysis adequacy” is less appropriate because delivered clearance and symptoms both show inadequate treatment “Increase ultrafiltration only when volume assessment supports additional removal” is less appropriate because this worsens haemodynamic risk without restoring solute removal “Use antiemetics while investigating and correcting the cause of persistent symptoms” is less appropriate because symptom control does not correct underdialysis “Discuss conservative care when burdens outweigh benefits after shared assessment” is less appropriate because social and prescription barriers should be addressed before abandoning life-sustaining treatment

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