Which clinical finding may prompt reassessment of PD prescription and dietary guidance?

Which clinical finding may prompt reassessment of PD prescription and dietary guidance?

• A. Hypotension
• B. Weight gain and edema
• C. Weight loss
• D. Increased urine output

Answer: (B)

Weight status and fluid balance are central in PD management. When a patient has weight gain accompanied by edema, it signals fluid overload, meaning the current PD regimen isn’t removing enough fluid relative to intake or the sodium-driven thirst is high. That situation calls for reassessing the PD prescription to enhance ultrafiltration and revisiting dietary guidance to limit fluids and sodium. In practice, you might adjust the dialysis plan by increasing dwell time or dialysate volume, or using a more effective osmotic strategy for long dwells (such as icodextrin) to boost fluid removal, while staying within the patient’s tolerance. Pair these changes with stricter fluid and sodium restrictions and check on residual kidney function and overall dialysis adequacy. Other findings, like hypotension, weight loss, or increased urine output, point to different issues (overly aggressive ultrafiltration, nutritional risk, or preserved native kidney function) and don’t directly indicate this specific reassessment focus.

Weight status and fluid balance are central in PD management. When a patient has weight gain accompanied by edema, it signals fluid overload, meaning the current PD regimen isn’t removing enough fluid relative to intake or the sodium-driven thirst is high. That situation calls for reassessing the PD prescription to enhance ultrafiltration and revisiting dietary guidance to limit fluids and sodium. In practice, you might adjust the dialysis plan by increasing dwell time or dialysate volume, or using a more effective osmotic strategy for long dwells (such as icodextrin) to boost fluid removal, while staying within the patient’s tolerance. Pair these changes with stricter fluid and sodium restrictions and check on residual kidney function and overall dialysis adequacy. Other findings, like hypotension, weight loss, or increased urine output, point to different issues (overly aggressive ultrafiltration, nutritional risk, or preserved native kidney function) and don’t directly indicate this specific reassessment focus.