Abstract:

This report presents a rare case of end-stage renal disease (ESRD) with abnormally elevated β-human chorionic gonadotropin (β-hCG), analyzes its clinical characteristics, diagnostic considerations, and the potential mechanism underlying β-hCG elevation, aiming to raise awareness of non-pregnancy and non-neoplastic β-hCG elevation in ESRD patients. The patient is a 35-year-old woman who had been on maintenance hemodialysis (MHD) for more than 7 years and was admitted due to amenorrhea lasting over 6 months. Laboratory tests showed elevated serum β-hCG. Gynecological ultrasound showed no signs of pregnancy. Ectopic pregnancy was initially suspected but ruled out after comprehensive evaluation. Based on literature review, the β-hCG elevation was considered to result from reduced renal clearance caused by ESRD. The patient continued MHD treatment with regular β-hCG monitoring and developed no new symptoms. This case indicates that when β- hCG is elevated in ESRD patients, it is essential to first exclude common etiologies such as pregnancy and neoplasms through detailed history, imaging, and laboratory examinations, while also considering the impact of renal failure on β-hCG metabolism. Clinicians should broaden diagnostic thinking to avoid misdiagnosis and promote precise diagnosis and management of complications in ESRD.

Key words: End-stage renal disease, Chorionic gonadotropin, beta subunit, human, Continuous renal replacement therapy, Pregnancy, ectopic, Gestational trophoblastic disease