CSR Electrolyte Management in Renal Disease

Question 1

A hemodialysis patient presents with a pre-dialysis serum potassium of 7.0 mEq/L and ECG changes (peaked T waves, widened QRS). Which food should be IMMEDIATELY eliminated from the diet?

Accepted Answer

Bananas, oranges, potatoes, and tomatoes

Answer

White rice and pasta

Answer

Chicken breast and fish

Answer

White bread and crackers

Question 2

In managing dietary phosphorus in CKD, which type of dietary phosphorus has the LOWEST bioavailability and is therefore least harmful?

Accepted Answer

Organic phosphate from plant sources bound to phytate

Answer

Inorganic phosphate from food additives (phosphoric acid, sodium phosphate)

Answer

Organic phosphate from animal sources (meat, dairy, fish)

Answer

All forms of phosphate are equally bioavailable

Question 3

A peritoneal dialysis patient has persistent hypomagnesemia (Mg 1.4 mEq/L). Which dietary counseling is appropriate?

Accepted Answer

Encourage adequate intake of magnesium-rich foods (nuts, seeds, legumes, whole grains) and consider oral magnesium supplementation after physician review

Answer

Restrict all magnesium-containing foods as magnesium accumulates in dialysis

Answer

Recommend magnesium-containing laxatives freely as they are safe in PD

Answer

Hypomagnesemia is not clinically significant in renal patients

Question 4

Which clinical condition is MOST associated with hyponatremia in CKD patients and is directly managed through fluid restriction?

Accepted Answer

Dilutional hyponatremia from fluid overload and impaired free water excretion

Answer

Dehydration from excessive sweating

Answer

Hyperaldosteronism causing sodium retention

Answer

Excessive dietary sodium intake

Question 5

The dialysis patient's 'dry weight' is a critical parameter in managing fluid and sodium balance. How is dry weight BEST defined?

Accepted Answer

The lowest weight a patient can tolerate at the end of dialysis without symptoms of hypotension or cramping, representing euvolemic status

Answer

The patient's weight after a full night's sleep without eating

Answer

The ideal body weight calculated from standard height-weight tables

Answer

The pre-dialysis weight minus 2 kg

Question 6

Calcium-phosphate product (Ca × P) is monitored in dialysis patients to assess risk of vascular calcification. What product value is generally associated with increased calcification risk?

Accepted Answer

Ca × P > 55 mg²/dL²

Answer

Ca × P > 35 mg²/dL²

Answer

Ca × P > 75 mg²/dL²

Answer

Ca × P > 20 mg²/dL²