Which symptom would most likely indicate fluid overload in a patient with CKD?

The presence of periorbital edema is a strong indicator of fluid overload in a patient with chronic kidney disease (CKD). In CKD, the kidneys lose their ability to properly filter and excrete waste and excess fluids from the body. This inability can lead to a buildup of fluid, manifesting as edema in various areas, particularly around the eyes.

Periorbital edema specifically occurs when excess fluid accumulates in the tissues around the eyes, which is one of the observable signs of fluid overload. In patients with CKD, signs of fluid retention—such as edema—are significant as they reflect the kidneys' inability to maintain fluid balance.

In contrast, dehydration, dry mouth, and weight loss are typically signs of fluid deficit rather than overload. Dehydration suggests inadequate fluid levels, while dry mouth often accompanies low fluid intake or increased fluid loss. Weight loss can indicate a lack of nutritional intake or excessive fluid loss rather than retention, further distinguishing these symptoms from the fluid overload scenario associated with CKD.