A nurse is providing education to a client starting hemodialysis. The client asks about dietary restrictions. Which of the following nutrients should the nurse recommend limiting for a client on hemodialysis?

A) This statement is incorrect. Hypokalemia (low potassium levels) is not an indication for initiating dialysis. In AKI, electrolyte imbalances can occur, but hyperkalemia is more likely due to impaired kidney function.

B) This statement is incorrect. Hyponatremia (low sodium levels) is not a primary indication for initiating dialysis in AKI. It can occur due to fluid shifts, but the primary concern in AKI is the accumulation of waste products like urea, leading to uremia.

C) This statement is incorrect. Hypernatremia (high sodium levels) is not a primary indication for initiating dialysis in AKI. Hypernatremia is rare in AKI and usually occurs when there is a significant loss of free water compared to sodium intake.

D) Uremia, which is characterized by elevated levels of urea and other waste products in the blood, is a critical indication for initiating dialysis in clients with acute kidney injury. Dialysis helps remove these toxic substances from the bloodstream.

A) This statement is accurate. Clients on hemodialysis should limit their protein intake to reduce the workload on the kidneys and minimize waste buildup. Excess protein intake can lead to the accumulation of urea and other waste products, which can be challenging for the compromised kidneys to eliminate.

B) This statement is incorrect. While clients on hemodialysis may need to limit sodium intake to manage fluid retention and blood pressure, the primary nutrient that requires limitation in their diet is protein.

C) This statement is incorrect. Clients on hemodialysis may need to monitor their calcium intake, but it is not the primary nutrient that requires limitation in their diet. Calcium levels may be affected by the use of phosphate binders and the avoidance of high-phosphorus foods, but protein restriction is more critical.

D) This statement is incorrect. Iron intake may need to be managed for clients with anemia, which is common in end-stage renal disease (ESRD) and dialysis. However, protein restriction remains a more significant dietary consideration for clients on hemodialysis.