According to the National Kidney Foundation, “Black or African Americans are almost four times more likely and Hispanics or Latinos are 1.3 times more likely to have kidney failure compared to White Americans. Although they make up only 13.5% of the population, Black or African Americans make up more than 35% of dialysis patients.”
This may be an unfortunate reality for many people of color, but knowing and understanding what is impacting our various communities’ health and livelihoods is essential to sustaining and improving our quality of life, and to better supporting ourselves or loved ones as health realities transition.
The Truth about Dialysis
Beginning dialysis can be very scary and seem like an impossible feat. But educating yourselves about what dialysis is, how it works, and how to prepare for treatment is key to helping ease some of those fears and becoming better advocates for yourselves or a loved one.
Montrez Lucas, LMSW, a former dialysis social worker, spoke with us about the realities of dialysis, offering practical, easily applicable advice to help patients prepare for this new season in their health journey.
Dialysis: A Practical Guide
OHOW: If you were speaking to a newly diagnosed kidney disease patient, how would you explain dialysis?
Lucas: When I first sat with patients, I always started here… because this moment can feel overwhelming…
Dialysis is not a cure, but it helps your body keep going when your kidneys need support. Your kidneys normally clean your blood by removing waste and excess fluid, and by balancing important minerals. Dialysis steps in to do that job.
OHOW: What is dialysis’ primary function and how does it physically work?
Lucas: There are two main types, but most patients I worked with were on hemodialysis. In simple terms, your blood is gently taken out of your body through a special access point, passed through a filter (sometimes called an artificial kidney), and then returned to you, cleaned. This happens over a few hours, usually several times a week.
What I always emphasized is this: dialysis is not just a machine; it is a bridge that helps you continue living your life while managing kidney disease.
OHOW: What would you recommend a newly diagnosed patient do to prepare their body and life before beginning dialysis treatment?
Lucas: I would gently remind patients that preparation is not just physical; it is emotional, practical, and social.
Physically, your {medical} care team may guide you in adjusting your diet, often focusing on fluid intake, sodium, potassium, and phosphorus. This can feel restrictive at first, but it becomes more manageable with time and support.
Practically, dialysis will take up several hours of your week, so it is important to start thinking about your schedule. Some patients adjust work hours, explore flexible arrangements, or plan treatments around their most important commitments.
But the most important preparation, in my experience, is building your support system. That can be family, friends, other patients, or even your care team. I have seen patients do so much better when they do not try to carry this alone.
I also strongly encouraged patients to ask questions and learn about their treatment, their options, and their rights. The more informed you are, the more empowered you feel.
OHOW: What should a new dialysis patient expect on their first day of treatment?
Lucas: The first day can feel like stepping into a completely new world, so I always tried to prepare patients for both the clinical and human side of it.
You will arrive at a dialysis center that has a structured, routine environment. There will be nurses, patient care technicians, a nephrologist overseeing care, and a social worker, someone in my former role, there to support you beyond the medical aspects.
You will be seated in a treatment chair, and the team will connect you to the dialysis machine through your access point. The staff will monitor you closely throughout the session, checking your blood pressure, ensuring everything is running smoothly, and making sure you are comfortable.
Physically, some patients feel fine during treatment, while others may feel a bit tired, lightheaded, or unsure at first. Emotionally, it is very normal to feel anxious, quiet, or even overwhelmed.
What I always told patients is this: you do not have to “get it right” on day one. Just showing up is enough.
OHOW: Post treatment, how might a typical patient feel? What are some common symptoms and best practices for recovery?
Lucas: After treatment, many patients feel tired. Some describe it as a deep fatigue, while others feel relatively normal. You might also experience mild dizziness, low blood pressure, muscle cramps, or a headache, especially in the beginning as your body adjusts.
One of the most important things I encouraged was listening to your body. Rest when you need to. Do not push yourself too hard on treatment days, especially early on.
Staying within your recommended fluid and diet guidelines can also help reduce symptoms between treatments.
Gentle routines, like light movement, consistent sleep, and planning something small and comforting after treatment, can make a big difference.
And importantly, speak up. If something feels off, your care team wants to know. Managing dialysis is a partnership.
OHOW: From your experience, what is one thing you could share that cannot be found in research or data?
Lucas: This is what I would always tell patients, and it is something I learned only by walking alongside them:
Dialysis will change your life, but it does not take away who you are.
The patients who navigated this journey best were not the ones who had it easiest medically. They were the ones who found ways to hold onto their identity, whether that was being a parent, a professional, a friend, a person with humor, faith, or purpose.
I saw patients bring blankets from home, build friendships in the dialysis chair next to them, celebrate milestones, and even laugh during treatment. Those moments matter more than any clinical data point.
So, my advice is this: allow yourself to grieve what has changed, but do not lose sight of what has not. You are still you, and there is still life to be lived within this.
About the Clinician
Montrez Lucas, LMSW, joined the International Society of Glomerular Disease (ISGD) in November 2025 as the Director of Strategic Operations and Events. In his current role, he oversees the execution, coordination, and delivery of ISGD’s global convenings, ensuring that the society’s initiatives operate with efficiency and have measurable impact.
Before joining ISGD, Montrez held multiple leadership roles at NephCure, one of the country’s leading organizations in rare kidney disease research, advocacy, and patient support. He began in 2022 as the Associate Director of Patient Navigation before advancing to Director of Patient Engagement in 2024. During this time, he guided patients, caregivers, and families through the complexities of rare kidney disease care, building relationships, reducing access disparities, and connecting patients and families with essential resources.
Though Montrez Lucas has held various roles during his career, it was his time as a lead social worker in a dialysis clinic in Jacksonville, Florida, that would change the trajectory of his work and help to solidify his focus and passion for the kidney disease patient, their experience, and their care.