A patient is undergoing regular hemodialysis. What is the correct ASA physical status classification for this patient?

Correct answer: C. ASA III

• A. INCORRECT. ASA I is a normal, healthy patient with no systemic disease. A patient on regular hemodialysis has end-stage renal disease (ESRD) — a significant systemic condition.
• B. INCORRECT. ASA II includes patients with mild systemic disease that does not limit activity. ESRD requiring hemodialysis represents a severe limitation that goes beyond ASA II.
• C. CORRECT. A patient with end-stage renal disease (ESRD) undergoing regularly scheduled hemodialysis is classified as ASA III. Per the ASA classification system, ESRD on regular dialysis is explicitly listed as an ASA III example — it represents severe systemic disease that is a constant concern but not an immediate threat to life.
• D. INCORRECT. ASA IV is reserved for patients with severe systemic disease that is a constant threat to life (e.g., ESRD NOT on dialysis with refractory ascites, recent MI <3 months, decompensated CHF). A patient on regularly scheduled, stable dialysis is ASA III, not IV.