A nurse practitioner (NP) has accepted a position at a hemodialysis facility. What is the most significant complication of intermittent hemodialysis?

Choice A reason: Cerebral edema is a rare but serious complication associated more with rapid shifts in osmolality, such as in dialysis disequilibrium syndrome. It is not the most common or significant complication of routine intermittent hemodialysis. Choice B reason: Arrhythmias can occur due to electrolyte imbalances during dialysis, particularly with potassium shifts. However, they are less frequent and not as consistently observed as hypotension. Choice C reason: Hypotension is the most frequent and significant complication of intermittent hemodialysis. It results from rapid fluid removal, autonomic dysfunction, or impaired cardiac output. It can lead to dizziness, nausea, cramps, and even syncope, making it a critical concern during dialysis sessions. Choice D reason: Hypertension is a chronic issue in patients with kidney disease, but it is not a direct complication of the dialysis procedure itself. In fact, dialysis often helps manage fluid overload and blood pressure.