The Internal Medicine service at a hospital requests that one of their patients receive dialysis. Which of the following is NOT an indication for dialysis?
A. End-stage renal disease (GFR < 15 mL/min)
End-stage renal disease (GFR <15 mL/min). The indications for dialysis can be remembered with the mnemonic AEIOU: Acidemia, Electrolyte disturbance (hyperkalemia, hyper- or hypocalcemia, hyperphosphatemia, hyperuricemia), Intoxication (e.g., salicylates, methanol), Overload of volume, and Uremic complications. End-stage renal disease, defined as a GFR <15 mL/min, is not itself an indication for dialysis. Uremia is the clinical syndrome that accompanies renal failure, and is characterized by a decrease in the excretion of water and electrolytes, a decrease in the secretion of organic solutes (e.g., nitrogenous waste products), and a decrease in renal hormone synthesis (e.g., EPO). Three complications of uremia are indications for dialysis: pericarditis/pleuritis, encephalopathy, and bleeding diathesis (due to platelet dysfunction). There are a few other indications that are not represented in the mnemonic, and these are hypertension refractory to medications, malnutrition, and persistent nausea and vomiting.