A 63-year-old woman with a history of nearing end-stage renal disease presents with shortness of…

A 63-year-old woman with a history of nearing end-stage renal disease presents with shortness of breath and fatigue. Her blood pressure is 150/105 mm Hg and her heart rate is 115 beats per minute. Her point of maximum impulse (PMI) is displaced laterally. She has jugular venous distension and an S4 gallop. She has some crackles at the lung bases posteriorly but no peripheral edema. Laboratory data reveal elevation of the BUN and creatinine levels. Her serum potassium level is 6.0 mg/dL (normal range is 3.5-5.5 mg/dL). Electrocardiogram is normal. After 80 mg of furosemide, the patient is no longer short of breath and her potassium has improved. Which of the following is an indication for emergency dialysis in this patient? a. Blood pressure of 150/105 mm Hg b. Fluid overload c. Hyperkalemia d. Elevated BUN e. Elevated creatinine level f. There is no need for emergency dialysis

 

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