CCHT Interpretation of Common Laboratory Values 2

Question 1

A hemodialysis patient's serum phosphorus is 7.8 mg/dL. Which of the following is the most appropriate dietary recommendation to address this finding?

Accepted Answer

Restrict foods high in phosphorus such as dairy, nuts, and cola drinks

Answer

Increase dietary protein intake to improve nutritional status

Answer

Increase dietary potassium to balance electrolytes

Answer

No dietary change is needed; adjust phosphate binders only

Question 2

What does a Kt/V value of 1.2 indicate about a hemodialysis patient's treatment adequacy?

Accepted Answer

The patient is receiving the minimum adequate dose of dialysis per current guidelines

Answer

The patient is receiving inadequate dialysis and the treatment time or blood flow rate should be increased

Answer

The patient is being over-dialyzed and the treatment time should be reduced

Answer

The Kt/V value is unrelated to treatment adequacy in hemodialysis

Question 3

Which laboratory value is used to assess long-term glycemic control in a dialysis patient with diabetes?

Accepted Answer

Hemoglobin A1c (HbA1c)

Answer

Fasting blood glucose

Answer

Serum insulin level

Answer

C-peptide level

Question 4

A hemodialysis patient's monthly labs show serum potassium of 6.8 mEq/L. What is the most urgent concern?

Accepted Answer

Risk of fatal cardiac arrhythmias

Answer

Development of metabolic acidosis

Answer

Worsening renal bone disease

Answer

Increased risk of muscle cramps during dialysis

Question 5

What is the target range for serum intact parathyroid hormone (iPTH) in patients on maintenance hemodialysis?

Accepted Answer

150–600 pg/mL (2–9 times the upper limit of normal)

Answer

10–65 pg/mL (normal range for healthy adults)

Answer

600–1000 pg/mL

Answer

1000–1500 pg/mL

Question 6

A patient's pre-dialysis serum bicarbonate is 14 mEq/L. What condition does this suggest and what is the appropriate response?

Accepted Answer

Metabolic acidosis; consider increasing dialysate bicarbonate concentration and notify the care team

Answer

Metabolic alkalosis; reduce dialysate bicarbonate concentration

Answer

Respiratory acidosis; prepare for non-invasive ventilation

Answer

Normal finding in dialysis patients; no action needed