A dialysis patient who misses several sessions may present with symptoms that mimic which condition?

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

Answer: (D)

When a dialysis patient skips sessions, the body can’t remove excess fluid and waste, leading to volume overload. The extra fluid raises circulating volume and pressures in the heart and lungs, causing pulmonary edema and peripheral edema. This produces symptoms that closely resemble congestive heart failure: shortness of breath, crackles heard on lung exam, leg swelling, weight gain, and sometimes hypertension and a rapid pulse. Dehydration would more likely cause dry mucous membranes, rapid heart rate with low or normal blood pressure and no edema. A stroke would present with neurologic deficits, not primarily fluid overload symptoms. Emphysema involves chronic lung changes rather than acute fluid overload. So the situation most closely mimics congestive heart failure due to volume overload from missed dialysis.