Miss Soobin Choi1
1Northern Beaches Hospital, Sydney, Australia
Biography:
Soobin Choi is a registered nurse working in the Dialysis Unit at Northern Beaches Hospital in Sydney, Australia. She has two years of clinical experience in renal nursing, caring for patients with acute kidney injury and chronic kidney disease across inpatient and outpatient settings. Her clinical interests include early identification of renal deterioration, outpatient surveillance, and timely planning for kidney replacement therapies. She is particularly interested in how progressive kidney disease may occur with minimal symptoms and how proactive monitoring can improve patient outcomes. This case presentation reflects her commitment to patient-centred, evidence-informed renal nursing care.
Abstract:
Acute kidney injury is a common clinical condition that may progress to chronic kidney disease despite apparent recovery. In some patients, deterioration in renal function may occur in the absence of overt clinical symptoms, creating challenges for timely recognition and intervention. This case report describes progressive renal dysfunction identified through routine outpatient follow-up in a clinically stable patient.
A patient was reviewed in a nephrology outpatient clinic six weeks after initial assessment. Routine blood tests demonstrated a significant decline in kidney function compared to previous results. Despite biochemical deterioration, the patient denied symptoms such as reduced urine output or fluid overload and remained clinically stable. Further investigations confirmed progressive renal impairment. Following multidisciplinary discussion, the decision was made to proceed with early arteriovenous fistula creation in anticipation of future kidney replacement therapy. The patient remained largely asymptomatic during follow-up. Renal function continued to decline, ultimately necessitating preparation for long-term renal replacement therapy.
This case highlights the importance of vigilant outpatient monitoring in patients at risk of renal deterioration. The absence of symptoms may delay recognition of disease progression and appropriate intervention. Clinical stability does not necessarily correlate with preserved renal function, and reliance on symptom burden alone may underestimate disease severity. This case is particularly relevant for clinicians and renal nurses involved in outpatient surveillance and long-term kidney care planning.
Asymptomatic progression of kidney dysfunction can occur despite apparent clinical stability. Regular biochemical monitoring and proactive planning are essential to facilitate timely intervention and optimise patient outcomes.