Chronic kidney disease in young age: A case report of early diagnosis and comprehensive management

Abstract

Chronic kidney disease (CKD) is characterized by progressive and irreversible deterioration of kidney function. Although it is more commonly found in older individuals, CKD can also occur at a young age and may result in significant long-term complications. A 17-year-old female with Stage 5 CKD undergoing regular hemodialysis presented with shortness of breath for 2 days, difficulty sleeping, cough with initially pink-colored sputum, fever, and decreased urine output. Physical examination revealed bilateral conjunctival pallor and bilateral rhonchi. Laboratory examination showed elevated urea (99 mg/dL) and creatinine (6.77 mg/dL), decreased hemoglobin (10.4 g/dL) and hematocrit (31.7%), as well as decreased bicarbonate levels (17.6 mmol/L), suggesting metabolic acidosis. Renal ultrasonography demonstrated bilateral small kidneys with increased parenchymal echogenicity and indistinct corticomedullary differentiation, consistent with a chronic renal process. Chest radiography revealed cardiomegaly. The patient was managed with regular hemodialysis, fluid management, antihypertensive therapy, and supportive treatment. This case highlights the occurrence of advanced CKD in a young patient and its associated complications, including respiratory symptoms, anemia, metabolic acidosis, severe hypertension, and cardiomegaly.