Which of the following is a typical sign or symptom of end-stage renal disease?

• A. Metabolic acidosis
• B. Rash on skin
• C. Dry cough
• D. Headache only

Answer: (A)

Metabolic acidosis is a direct consequence of very reduced kidney function. When the kidneys fail, they’re unable to excrete acids efficiently and to regenerate bicarbonate, so hydrogen ions accumulate and bicarbonate levels drop. This disruption of acid-base balance is a common and characteristic finding in end-stage renal disease, often contributing to symptoms like fatigue and rapid breathing as the body tries to compensate. The other options don’t specifically reflect the kidney’s impaired ability to manage acid-base balance—rash on the skin, a dry cough, or a headache can arise from many other causes and are not typical hallmarks of ESRD.