Francis M., 17

Francis resides with his widowed father, who works as a casual laborer to support their family of five children. Despite facing financial hardships, Francis is a humble and ambitious young man with aspirations of becoming a teacher. Unfortunately, his education was interrupted due to challenges with school fees. Recently, Francis has been experiencing intermittent body swelling, accompanied by facial puffiness that worsens in the morning. Concerned about his deteriorating health, his aunt intervened upon visiting the family and witnessing his condition. Recognizing the financial constraints preventing his father from seeking medical help, she promptly took Francis to Consolata Hospital Nkubu for treatment.

The patient presented with facial swelling and progressively worsening generalized body puffiness. He appeared very ill, had difficulty breathing, and was noticeably restless upon arrival at the hospital. One of the most concerning signs was his significantly elevated blood pressure. After a series of investigations, including kidney function tests and a kidney ultrasound, he was diagnosed with nephrotic syndrome, severe hypertension, and acute kidney injury. He also had a dangerously high level of potassium in his blood—a condition known as hyperkalemia. This can be life-threatening, as it can lead to serious heart rhythm disturbances or even cardiac arrest. Immediate intervention was necessary, and measures were taken to shift potassium out of his bloodstream to safer levels. Once stabilized, with his blood pressure under control and the excess fluid managed—easing his breathing—he was referred for dialysis. By then, he was in a stable condition. A recent follow-up indicated that he is doing well. His overall condition has greatly improved compared to when he first arrived, and his mother has expressed heartfelt gratitude for the care he received.

Nephritic syndrome can progress to acute kidney injury (AKI) if left untreated. It is often associated with inflammatory markers in the blood and may have a rapid onset. The treatment includes medications to reduce inflammation, control blood pressure, manage edema, and treat any underlying infections or systemic diseases. Francis is referred for kidney biopsy. In some cases, immunosuppressive therapy is needed.