Leah C., 14

Chepkorir comes from an extremely disadvantaged socio-economic background that has significantly affected her health and overall well-being. Her family survives on irregular and minimal income, which is barely enough to meet daily food needs, leaving no resources for healthcare, education, or other basic necessities. The family lives in poor housing conditions, often in a small, overcrowded structure constructed from temporary materials. The house provides little protection from harsh weather, has inadequate ventilation, and lacks access to electricity and safe drinking water. Sanitation is poor, with no proper toilet facilities, forcing the family to rely on unsafe alternatives. These conditions expose them to frequent infections and preventable illnesses. Due to severe financial constraints, the family is unable to afford basic medical care. Illnesses are often managed at home or left untreated until they become severe, increasing the risk of complications. Education has also been disrupted, as the family cannot afford school fees, uniforms, or learning materials, leading to interrupted schooling and dropout. Chepkorir was brought to the facility by her mother with complaints of swelling of the lower limbs and facial puffiness that had persisted for two weeks. She is a known patient with type 1 diabetes mellitus and has been on insulin therapy since the age of five. She has experienced recurrent episodes of illness due to fluctuating blood sugar levels, including hypoglycaemia, which has resulted in multiple hospital admissions. Her mother reported that Chepkorir had been passing very dark, scanty urine with reduced frequency, sometimes as little as once per day, as well as foamy urine. She also had reduced appetite, severe vomiting for two days, and a cough producing yellowish sputum occasionally streaked with blood. Based on clinical examination and laboratory investigations, Chepkorir was diagnosed with acute kidney injury, hypoglycaemia, and anaemia. She was admitted for treatment, further investigations, and comprehensive medical management.

Chepkorir came in the facility accompanied by her mother with complains of; lower limb swelling and facial puffiness in the last two weeks. Chepkorir is known diabetic type one in insulin since she was 5 years old,she has been unwell on and off due to fluctuating sugars with hypoglycemia leading to several admissions. On examination and laboratory investigation she was diagnosed with acute kidney injury, hypoglycemia and anemia, she put under medication and responded well after awhile and discharged on a good condition.

Chepkorir is a known diabetic patient who has developed multiple serious complications, including acute kidney injury (AKI), anemia, and unstable blood glucose levels characterized by episodes of hypoglycemia and hyperglycemia. The doctor’s opinion is that her condition is critical but potentially reversible if managed promptly and comprehensively. The acute kidney injury is likely related to poorly controlled diabetes, possible dehydration, infection, or drug-related factors, and it requires close monitoring of renal function, fluid balance, and electrolytes. The presence of anemia further worsens her general condition by reducing oxygen delivery to tissues, increasing fatigue, and placing additional strain on the heart and kidneys. Fluctuating blood sugar levels indicate poor glycaemic control, increasing the risk of neurological symptoms, cardiovascular instability, and further kidney damage. The prognosis is good, With timely intervention—such as careful blood glucose regulation (insulin adjustment and monitoring), correction of hypoglycemia, treatment of underlying causes of AKI, appropriate fluid management, anemia correction, and prevention or treatment of infection—renal function .