The Power of Choice: Sustaining Identity Beyond Kidney Disease

Therapy Options • Peritoneal Dialysis • Chronic Kidney Disease (CKD)

Ethan, age 26, is from the charming town of Silly, just outside Brussels, Belgium. His life mirrors that of many young adults, shaped by work he values, people he loves, and plans that extend well beyond today. As a veterinarian, he has dedicated his life and career to working with animals, drawn to a profession that reflects his sense of responsibility and care for others. He and his fiancée, Marin, are planning a future built around shared experiences, family, and continued travel, including trips with his younger brother that have become a meaningful tradition.

Then chronic kidney disease (CKD) entered his life, suddenly and without warning.

Due to a genetic condition, Ethan’s kidney function rapidly declined, progressing to end-stage renal failure. To survive, he needed to begin dialysis treatment immediately. Like many people with CKD, he had no clear symptoms until the disease had already advanced.

When Ethan learned he needed dialysis right away in order to survive, he made a clear decision about how he would face it:

“I have always been someone who wants to fight,” Ethan said. “I don’t want the disease to define me as a person.”

Ethan's determination reflects a broader reality — he is far from alone. More than 850 million people globally are living with some form of kidney disease¹, and many, just as Ethan once was, don't even know it. Without intervention, CKD is projected to become the fifth leading cause of death globally by 2040.²

Understanding Your Choices

When Ethan was suddenly diagnosed with end-stage renal failure, he faced an urgent and life-altering decision. Rather than navigating it alone, he and his doctor worked through the options together — weighing the clinical evidence alongside what mattered most to Ethan personally. The stakes were high: the treatment he chose would touch every aspect of his daily life, from how he worked and traveled to how much control he had over his own routine. Together, they talked through the two main dialysis options:

Hemodialysis (HD): Usually performed in a clinic several times a week on a fixed schedule.
At-Home Peritoneal dialysis (PD): Performed overnight during sleep, often offering greater flexibility and independence.

Ethan’s doctor explained how each therapy works, along with the benefits and risks of both. They also discussed how both treatments might affect Ethan’s work, his independence, and his ability to travel. These conversations helped Ethan choose a path that fits the life he wanted to continue living.

Shared decision-making turned a medical emergency into a personal choice.

He chose PD, a decision that allows him to stay present in the life he'd built. He remains engaged in his work and continues to make memories with the people who matter most to him, including his brother, who recently joined him on a trip to Disneyland Paris.

More Than a Diagnosis

Ethan still shows up for the animals in his care. He's continuing to build a future with Marin, enjoying time with his brother, and chasing the next adventure — this time, to Japan.

Kidney disease may have changed his path, but by working with his care team to find the right treatment for him with PD, it never changed his destination. Ethan's story embodies the spirit of World Kidney Day: an informed patient making an empowered choice in collaboration with his care team.

Yet of the more than 850 million people globally living with some form of kidney disease, many don't understand their risks or that treatment options exist that can better fit the life they want to keep living. Education, early detection, and shared decision-making have the power to change that.

Ethan said he was someone who wanted to fight. He still is. On World Kidney Day, his story is a call to action — for patients, caregivers, and healthcare providers alike — to ensure that no one faces this disease without the information and support they need to keep moving forward.

References

Jager K. J., et al. A single number for advocacy and communication—worldwide more than 850 million individuals have kidney diseases. Nephrol Dial Transplant 2023;34:1803–1805.
Foreman KJ, et al. Forecasting life expectancy, years of life lost, and cause-specific mortality for 250 causes of death: Global Burden of Disease Study. The Lancet, 2018. https://www.thelancet.com/article/S0140-6736(18)31694-5/fulltext