A 47-year-old woman presents to the clinic with complaints of persistent fatigue, nausea, and a general feeling of unwellness over the past few months. She has a long history of chronic back pain, for which she has been taking over-the-counter analgesics, including high doses of acetaminophen and ibuprofen, for several years. Recently, she has also noticed a decrease in urine output and has been experiencing mild flank pain.

On examination, she appears fatigued and slightly dehydrated, with a blood pressure of 135/85 mmHg. Laboratory tests reveal an elevated serum creatinine level of 2.1 mg/dL, indicating impaired renal function. A urinalysis shows mild proteinuria and the presence of hyaline casts. A renal ultrasound reveals normal kidney size but some echogenicity, suggesting possible chronic changes.

Given her history of long-term analgesic use and the clinical findings, the patient is diagnosed with analgesic nephropathy. She is advised to stop all non-prescription analgesics immediately and is started on hydration therapy to support her kidney function. The patient is educated about the risks associated with chronic analgesic use and the importance of monitoring her kidney function regularly. She is scheduled for follow-up appointments to assess her renal status and to discuss alternative pain management strategies.