What is the likely factor contributing to shortness of breath in a patient who missed dialysis?

Fluid overload is a common and likely factor contributing to shortness of breath in a patient who has missed dialysis. Patients on dialysis often have their fluid intake and removal carefully managed to avoid excess fluid accumulation in the body. When a patient misses a session, they can experience an increase in fluid retention, which can lead to pulmonary edema—fluid buildup in the lungs. This condition can cause shortness of breath, as the excess fluid interferes with normal gas exchange in the lungs, leading to difficulty breathing.

In addition to fluid overload, factors such as diabetes management issues or heart failure could potentially lead to breathing difficulties, but they are less specific to the context of missed dialysis. Chronic obstruction typically refers to conditions like COPD, which would not be directly related to the effects of missing dialysis. Thus, fluid overload directly connects to the missed dialysis situation, making it the most likely contributor to the patient's shortness of breath.