If a patient with end-stage renal disease misses several dialysis treatments, which complication is most likely to occur?

In patients with end-stage renal disease, the kidneys are unable to adequately remove waste products and excess fluids from the body. Dialysis serves as a critical treatment to perform these functions artificially. When a patient misses several dialysis treatments, one of the immediate consequences is the accumulation of excess fluids in the body.

Pulmonary edema is a serious complication that can arise when fluid builds up in the lungs due to insufficient dialysis. This occurs because the kidneys cannot effectively manage fluid balance, leading to an overload that the body cannot handle. The excess fluid can cause the lungs to fill with fluid, resulting in difficulty breathing and other respiratory distress symptoms.

Additionally, although dehydration, potassium depletion, and bacterial infections are concerns for dialysis patients, they are less likely to be the primary complication after missing multiple sessions of dialysis. Instead, fluid overload is the most imminent risk, making pulmonary edema the most likely complication in this scenario.