Chronic Renal Failure: A Case Study of a 39-Year-Old Woman Managed with Haemodialysis

Abstract

Chronic renal failure, commonly described within the broader term Chronic Kidney Disease (CKD), is a progressive loss of kidney structure or function that can eventually result in kidney failure and the need for renal replacement therapy. This case study describes the assessment, medical management, and nursing care of a 39-year-old woman who was admitted to Kwara State University Teaching Hospital, Ilorin, with severe clinical features compatible with advanced renal dysfunction. The patient presented with a two-week history of fever, generalized body weakness, and nausea, and a four-day history of generalized body swelling. They were a known hypertensive patient. Physical assessment identified elevated blood pressure, pallor, reduced urine output, foamy urine, peripheral oedema, and difficulty breathing. Laboratory investigations showed severe renal impairment, with serum creatinine of 1323 µmol/L and urea of 18.3 mmol/L. Electrolyte abnormalities included sodium of 124 mmol/L and potassium of 5.7 mmol/L. Severe anaemia was also present, with haemoglobin of 5.6 g/dL and a documented packed cell volume of 17%. The patient was managed through a multidisciplinary approach involving medical review, nursing assessment, regular monitoring of vital signs and fluid status, prescribed medications, nutritional and psychological support, infection-prevention measures, haemodialysis and blood transfusion. Haemodialysis was documented on 19, 21 and 23 June 2025, and blood transfusion was undertaken during the final documented dialysis session following the low PCV. During hospitalization, generalized oedema reduced and the patient's blood pressure improved from 175/120 mmHg on admission to 130/87 mmHg. Their pulse and respiratory rate were also within the documented improved range before discharge. The case demonstrates the systemic consequences of severe renal impairment and the importance of early recognition, close laboratory and clinical monitoring, safe dialysis care, management of anaemia and comprehensive nursing education. It also highlights the need for continuity of renal replacement therapy, blood-pressure control, dietary and fluid management, adherence to prescribed treatment and regular follow-up after discharge.