What is the recommended action if there is persistent blood in dialysate without other symptoms?

• A. Evaluate for catheter irritation or bleeding; review recent catheterization; if persistent or heavy, seek medical evaluation.
• B. Ignore and continue exchanges.
• C. Increase dialysate volume.
• D. Change to hemodialysis immediately.

Answer: (A)

When blood appears in the dialysate persistently, the priority is to check for mechanical irritation or bleeding at the catheter site and review any recent catheterizations or manipulations. This helps identify potential sources of trauma or recent procedures that could explain the bleeding. If the bleeding continues or is heavy, medical evaluation is needed to rule out more serious issues and ensure appropriate management. Ignoring it, increasing the dialysate volume, or switching to hemodialysis immediately are not appropriate responses based on this sign alone; escalate to the dialysis team for assessment and guidance.