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Kidney failure

Kidney failure means kidneys that filter the blood less and less well. The waste and water the body should be getting rid of build up, which shows as stubborn fatigue, sometimes nausea and rising blood pressure. For a long time nothing shows, which makes the condition hard to explain.

At the most advanced stages, kidney function has to be replaced: dialysis filters the blood in their place, several hours and several times a week, or else a transplant takes over. Between sessions, food and drink are closely managed, and life is organised around these constraints more than the other way round.

Thirst becomes a matter of arithmetic for many people with advanced kidney failure: every glass of water, every soup, every juice-heavy fruit counts toward a daily total that must not be exceeded, because the kidneys no longer clear the surplus. Turning down a coffee or a cold drink isn't a whim, it's a safety rule.

On top of this comes the rhythm of dialysis, which splits the week into before and after each session. People often come out drained, needing time to recover, before the cycle starts again. This alternation is wearing and largely invisible to those around them, who only see the good days.

Invisible fatigue and constraints

Kidney failure often advances without any dramatic sign, then settles into the smallest detail of daily life. Fatigue can't be summoned on command, food is closely watched (salt, potassium, phosphorus, fluids), and medical appointments set the pace of the schedule. None of this can be read on a face.

  • fatigue that doesn't ease with rest, especially at the end of the day;
  • precise dietary restrictions, hard to keep to during shared meals;
  • for people on dialysis, several half-days taken up each week;
  • a strong vulnerability to cold, dehydration and infections.

What actually helps

The main support is organisation: being able to fit your obligations around care without having to justify it. RQTH (official recognition as a worker with a disability, in France), obtained through the MDPH (the French disability rights office), makes it possible to adjust the workstation and hours; for a child, a PAP (a personalised support plan at school, in France) or a PPS (an individualised schooling plan, in France) adapts schooling to absences and fatigue.

  • flexible hours and dialysis sessions taken into account;
  • easy access to water and toilets, without having to ask;
  • the chance to catch up on classes or work missed after a session;
  • understanding on the days after dialysis, which are often difficult.
Key figures

Kidney failure in a few figures

  • ~ 35.5 millionU.S. adults are estimated to have chronic kidney disease, about 1 in 7.Source: CDC.
  • ~ 9 in 10adults with chronic kidney disease do not know they have it.Source: CDC.
  • over 3 millionpeople in England live with chronic kidney disease (stages 3 to 5).Source: NHS.

Possible accommodations

Taking the care schedule and the fatigue into account already removes a great deal of pressure.

  • At school: put a PAP (a personalised support plan at school, in France) or a PPS (an individualised schooling plan, in France) in place, allow absences for care and catch-up, tolerate trips to the toilet and access to water.
  • At work: through RQTH (official recognition as a worker with a disability, in France), ease hours around dialysis, open up remote work on the days after a session, lighten physical tasks.
  • In daily life: respect the restrictions on drink and food without pressing, suggest activities that aren't tiring, plan ahead for cold and long journeys.

Explanations based on your profile

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Kidney failure explained to a Child

0–12 years old

The kidneys are like the body's little filters. They clean the blood by removing the things we do not want to keep. When they do not filter well, the waste stays in the body, a bit like a bin that does not get emptied.

This makes the person very tired, and they have to be careful about what they eat and drink. Sometimes, they have to go to the hospital several times a week for a machine that does the kidneys' job: this is called dialysis. It takes several hours each time.

It is like having a new rhythm of life: before and after the machine. But the grown-ups and the doctors help the person so that everything goes well.

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