Background: Chronic kidney disease (CKD) increasingly affects young adults. While hemodialysis is lifesaving, it imposes physical, psychological, social, economic, and spiritual burdens. Young adults face distinctive challenges related to identity formation, education, employment, and social relationships, which are often disrupted by treatment demands and illness uncertainty. Purpose: This review explores the multidimensional experiences of young adults with CKD on hemodialysis to inform holistic and age-sensitive nursing care. Methods: A narrative review was conducted using PubMed, Scopus, CINAHL, ScienceDirect, Google Scholar, and Garuda between 2018 and 2025. Fifteen studies meeting the inclusion criteria were thematically synthesized. Results: Six themes emerged: (1) Physical impact, such as fatigue, sleep disturbance, and intradialysis complications; (2) Psychological distress, including depression, anxiety, and body image concerns; (3) Economic burden, such as loss of income and family dependency; (4) Spirituality, including religious practices fostering hope and resilience; (5) Social support, such as family, peers, and community networks enhancing adherence; and (6) Coping strategies, including problem-focused coping, support groups, and spiritual practices. Some inconsistencies were noted regarding exercise and community-based programs, which appeared variably linked to coping and social support themes. Conclusion and Implications for Nursing: Young adults on hemodialysis experience interconnected physical, psychological, and social challenges that influence quality of life and adherence. Nurses should provide holistic, youth-centered interventions that integrate physical rehabilitation, counseling, financial guidance, and family and community engagement to promote adaptive coping and overall well-being.