What symptom indicates the need for dialysis in a child with chronic kidney disease?

Hypervolemia is a significant indicator for the need for dialysis in a child with chronic kidney disease (CKD). In CKD, the kidneys lose their ability to effectively excrete fluid and maintain fluid balance, leading to the accumulation of excess fluid in the body. This excess fluid can result in symptoms such as edema, hypertension, and congestive heart failure. When oral and medical fluid restrictions fail to alleviate these symptoms, dialysis becomes necessary to remove the excess fluid and restore balance.

The other conditions listed, while they may occur in children with CKD, do not typically indicate an immediate need for dialysis. For example, hypotension can occur in various scenarios, including dehydration, and does not inherently signal the need for dialysis. Hypokalemia, characterized by low potassium levels, might actually require treatment but does not usually prompt dialysis as a first-line intervention. Hypercalcemia, which is an elevated calcium level, can occur in CKD but is often managed with medication and dietary adjustments rather than dialysis. Thus, hypervolemia is the symptom most directly associated with the need for dialysis intervention in pediatric patients with chronic kidney disease.