Final answer:
In a patient with renal failure who has not received dialysis treatments, fluid overload is the expected fluid imbalance. This results from the kidneys' inability to properly excrete excess fluid, often leading to systemic edema and related complications. The correct option is C .
Step-by-step explanation:
When assessing a patient with renal failure who has not received dialysis treatments, one would typically expect to observe symptoms and signs consistent with fluid overload. Renal failure leads to a decrease in the glomerular filtration rate, which impairs the kidneys' ability to manage fluid and electrolyte balance. Conditions such as metabolic acidosis, hyperkalemia, and uremia are commonly associated with renal failure, but these are indications of the broader metabolic disarray rather than fluid balance per se.
Specifically, in the absence of dialysis, which serves as a mechanical means of filtering and cleaning the blood, patients with kidney failure often experience water and sodium retention, leading to systemic edema. Due to osmosis, water follows sodium, and as the damaged kidneys retain sodium, fluid retention is exacerbated. This process is a direct result of the kidneys' inability to adequately filter and excrete excess fluid from the body. Additionally, since antidiuretic hormone (ADH) plays a role in the kidneys' capacity to retain electrolytes and water, dysfunction in ADH production or response can further contribute to fluid overload.
Conversely, dehydration tends to be less common in untreated renal failure, as the kidneys are not properly excreting urine, resulting in fluid retention rather than loss. However, scenarios such as poor tubular reabsorption due to chronic renal disease with acidosis, or complications from diabetes mellitus could theoretically lead to increased fluid loss and dehydration, but this is not the typical presentation in patients not receiving dialysis treatments.