A 65-year-old male with a history of heart failure and chronic kidney disease (baseline creatinine 1.8 mg/dL) is admitted with worsening dyspnea and peripheral edema. His current creatinine is 3.5 mg/dL, and BUN is 60 mg/dL. Urine output is 10 mL/hour. Electrolytes show K 6.2 mEq/L and HCO3 15 mEq/L. Which intervention is most immediately indicated?
✓ Correct Answer: Option C
The patient exhibits severe hyperkalemia, metabolic acidosis, oliguria, and signs of volume overload refractory to conservative measures, indicating acute kidney injury with life-threatening complications that require urgent renal replacement therapy (hemodialysis).