Certified Dialysis Nurse Practice Test

Hyperkalemia is often the most commonly seen electrolyte imbalance in dialysis patients due to the kidneys' reduced ability to excrete potassium effectively. In patients with chronic kidney disease, the kidneys lose their ability to maintain normal potassium levels, leading to an accumulation of potassium in the blood.

During dialysis treatment, potassium is removed from the blood; however, patients can still experience hyperkalemia in between treatments, particularly if dietary potassium intake is not properly managed or if there are additional factors at play, such as tissue breakdown or hemolysis. Given that potassium plays a critical role in heart and muscle function, its excessive levels can lead to serious complications, including cardiac arrhythmias.

In contrast, the other electrolyte imbalances listed, such as hyponatremia, hypocalcemia, and hypercalcemia, can also occur in certain contexts among dialysis patients but are less frequently reported as the most common issue compared to hyperkalemia. For instance, hyponatremia may occur due to fluid overload or excessive intravenous fluid administration. Hypocalcemia can be a result of altered metabolism of vitamin D and increased phosphate levels often seen in renal failure. Hypercalcemia is less common but can occur due to disorders of calcium regulation, particularly in patients undergoing