Which of the following factors is a sign of poor candidacy for PD?

• A. Extensive abdominal adhesions
• B. All of the above
• C. Unrepaired hernias
• D. Malnutrition

Answer: (D)

Nutritional status is a primary factor in determining suitability for PD because good nutrition supports healing, immune function, and the body’s ability to handle the ongoing stresses of dialysis. Malnutrition, often reflected by low albumin or weight loss, signals a higher risk of complications such as infections and poor wound healing after catheter placement. This makes it harder for a patient to recover from the procedure and to maintain effective PD exchanges, leading to worse outcomes and technique failure.

Extensive abdominal adhesions or unrepaired hernias can complicate PD and may require careful surgical planning or alternative approaches, but they are not automatic disqualifications in all cases. Some patients with adhesions can still undergo PD with appropriate assessment and management, and hernias can sometimes be repaired or monitored appropriately to allow PD. The clear, direct risk that malnutrition presents to the safety and success of PD makes it the strongest indicator of poor candidacy in this context.