A patient undergoing regular hemodialysis attends the dental clinic. What is their ASA physical status classification?

According to the ASA Physical Status Classification, patients with end-stage renal disease (ESRD) undergoing regular scheduled dialysis are classified as ASA III (a patient with severe systemic disease but not an immediate threat to life). ASA III includes CKD stages 3-4 and ESRD on regular dialysis. These patients are considered high risk perioperatively and require careful pre-treatment evaluation including assessment of bleeding tendency (heparin used during dialysis), electrolyte status, and drug dosing adjustments. ESRD not on dialysis with uremia/volume overload would be classified ASA IV.