A 95-year-old male with chronic renal failure misses dialysis; which condition should you expect his symptoms to mimic?

• A. Dehydration
• B. Congestive heart failure
• C. Emphysema
• D. Stroke

Answer: (B)

Missing dialysis in chronic kidney failure allows fluid and waste to accumulate. The excess fluid causes volume overload, which can lead to pulmonary edema and systemic edema, producing shortness of breath, crackles on exam, hypertension, and possibly jugular venous distention. These signs closely resemble congestive heart failure, where the heart is overwhelmed by too much fluid. Dehydration would show volume depletion (dry mucous membranes, hypotension), emphysema presents with chronic lung changes, and stroke with focal neurological deficits, none of which fit the fluid-overload picture here. So the symptoms are most like congestive heart failure.