Preoperative assessment: ASA class for dialysis-dependent renal failure: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Preoperative assessment: ASA class for dialysis-dependent renal failure

Sample item

A 58-year-old man with end-stage renal disease attends thrice-weekly haemodialysis without missed sessions. He has no other significant illness and is listed for elective arteriovenous fistula revision. What is his ASA physical status?

AASA IVBASA VCASA IIDASA III

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. ASA III

In the ASA examples, end-stage renal disease on regularly scheduled dialysis is a severe systemic disease with functional limitation and falls in class III. Class IV is reserved for a constant threat to life, such as ESRD without regular dialysis or recent myocardial infarction.

Option by option

A. ASA IV
Class IV is a severe disease that is a constant threat to life; this man is stable on a regular programme.
B. ASA V
Class V is a moribund patient not expected to survive without the operation, which does not fit an elective fistula revision.
C. ASA II
Class II is mild systemic disease with no substantive limitation, such as well-controlled hypertension; dialysis dependence is more than that.
D. ASA III (correct)
Correct. ESRD maintained on regular dialysis is a severe but stable systemic disease, which is class III.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is D, ASA III. In the ASA examples, end-stage renal disease on regularly scheduled dialysis is a severe systemic disease with functional limitation and falls in class III.

Why is "ASA IV" not the answer?

Class IV is a severe disease that is a constant threat to life; this man is stable on a regular programme.

Why is "ASA V" not the answer?

Class V is a moribund patient not expected to survive without the operation, which does not fit an elective fistula revision.

Why is "ASA II" not the answer?

Class II is mild systemic disease with no substantive limitation, such as well-controlled hypertension; dialysis dependence is more than that.

What concept does this question test?

It tests Preoperative assessment: ASA class for dialysis-dependent renal failure in Anaesthesia. Class IV is reserved for a constant threat to life, such as ESRD without regular dialysis or recent myocardial infarction.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Preoperative assessment: ASA class for dialysis-dependent renal failure?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.