Which finding is common in a client who has chronic kidney disease (CKD)?

Choice A reason: Hypocalcemia is a classic finding in chronic kidney disease. As kidney function declines, the kidneys lose the ability to activate Vitamin D (calcitriol), which is necessary for intestinal calcium absorption. Additionally, the resulting hyperphosphatemia causes a reciprocal drop in serum calcium levels. This often leads to secondary hyperparathyroidism and renal osteodystrophy. Choice B reason: While fluid status can fluctuate, CKD patients are more commonly prone to fluid volume excess rather than dehydration. The kidneys lose the ability to excrete water and sodium effectively, leading to edema, hypertension, and heart failure. Dehydration usually only occurs if the patient is over-diuresed or has excessive gastrointestinal losses that they cannot compensate for. Choice C reason: Chronic kidney disease typically results in hyperkalemia, not hypokalemia. The kidneys are responsible for excreting 90% of the body's potassium. As the glomerular filtration rate (GFR) drops, potassium accumulates in the blood, posing a significant risk for cardiac dysrhythmias. Hypokalemia would be an unusual finding unless the patient is on specific wasting diuretics. Choice D reason: While sodium levels can vary, "hypernatremia" is not the most definitive common finding. Often, sodium is retained, but water is retained proportionally or in excess, leading to dilutional hyponatremia or a normal serum sodium level despite an overall increase in total body sodium. Hypocalcemia remains a more consistent metabolic hallmark across the stages of CKD.