skip to main content

Dialysis Modality Selection — RACP Adult Medicine MCQ

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

ModerateNephrologyDialysis Modality SelectionRACP Adult Medicine

A 72-year-old woman with end-stage renal disease is being assessed for renal replacement therapy. She has significant comorbidities including PVD, LVEF 35%, and BMI 38. She lives alone in a rural area 300 km from the nearest dialysis unit. What modality should be strongly considered?

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

Reveal the answer and explanation

Correct answer: D — Home peritoneal dialysis (CAPD or APD)

Home peritoneal dialysis (PD) is an excellent option for patients in remote/rural areas as it can be performed independently at home without the need for travel to a dialysis centre. It provides flexible scheduling, preserves residual renal function longer than HD, avoids vascular access complications, and supports patient autonomy. The PD-first approach is recommended by KHA-CARI for appropriate patients. Assisted PD (with community nurse support) is available for patients who need help. Training takes 1–2 weeks. Contraindications include extensive abdominal surgery and active abdominal infections.

Reference: KHA-CARI – 2013 – Dialysis Modality Selection; eTG – 2025 – Nephrology