Bleach and chloramines in dialysate primarily pose a risk of which complication?

The presence of bleach and chloramines in dialysate is particularly concerning because these substances can cause hemolysis, which is the destruction of red blood cells. When hemolysis occurs, it leads to the release of hemoglobin into the bloodstream, which can result in severe complications, including acute kidney injury, increased potassium levels, and even a potentially life-threatening situation.

When bleach or chloramines are present in the dialysate, they can damage the red blood cells directly or create an environment that makes hemolysis more likely. This can lead to a cascade of reactions in the body, causing significant complications that could ultimately result in death if not promptly addressed.

The other options do not relate directly to the risks posed by bleach and chloramines. Fluid overload is typically related to the volume status of the patient rather than the chemical composition of the dialysate. Hypoglycemia pertains to low blood sugar levels, not linked to these chemicals. Septic shock is associated with infections rather than exposure to substances in dialysate. Thus, the most accurate risk associated with bleach and chloramines is indeed death due to hemolysis.