Background: Chronic kidney disease (CKD) is a major global health concern, affecting around 850 million people and contributing significantly to morbidity and mortality. It is increasingly diagnosed in young adults, yet their experiences with long-term hemodialysis remain underexplored, particularly in nursing care. This study aims to explore their lived experiences. Objectives: To explore the lived experiences of young adults with CKD undergoing long-term hemodialysis. Methods: A qualitative study with a phenomenological approach was conducted in the hemodialysis unit of a public hospital in West Java, Indonesia. Five participants aged 22–29 years who had undergone hemodialysis for at least one year were recruited through purposive sampling. Data were collected through semi-structured, in-depth interviews and analyzed using Interpretative Phenomenological Analysis. Results: Five themes emerged: (1) Lifestyle Patterns and Delayed Recognition of Illness; (2) Emotional Responses and Disrupted Sense of Self; (3) Disrupted Social Relationships and Support Systems; (4) Physical Burden and Activity Limitation; and (5) Coping, Spirituality, and Hope for the Future. Hemodialysis was perceived as a life-altering event that affected independence, education, employment, and relationships. Participants described shock, fear, stress, and social withdrawal, especially in the early phase of treatment. Over time, family support, nurse engagement, peer interaction, and spiritual practices fostered acceptance, resilience, and sustained hope. Conclusion: Hemodialysis represents a profound multidimensional transition for young adults with CKD. Despite significant challenges, participants demonstrated adaptive coping and personal growth. Implications for Nursing Practice: Holistic, age-sensitive nursing care that integrates emotional support, family involvement, spiritual sensitivity, and individualized coping interventions is essential to enhance quality of life and long-term adaptation.