Initial reactions

Following a diagnosis of kidney failure (or any other serious long-term illness), people typically go through the following stages, which may occur one after the other, or in a different order, or overlap with each other. Some people miss stages altogether, and some think they have gotten over a certain feeling—only to have it return later. This is all part of coming to terms with what's happening, and although distressing, is a normal reaction to the situation.

Shock - At first, patients (and sometimes also family members and friends) may go into a state of shock—feeling bewildered or strangely detached—as though they are observing life rather than being a part of it. This shock can last a short while or may continue for many weeks.

Grief - Grief occurs when the reality of the situation is recognized (frequently after a period of shock). At this stage, people begin to react to the news, often with feelings of loss, helplessness and despair. Patients and those close to them may feel overwhelmed by reality and find it difficult to think clearly or plan effectively.

Denial - One very common reaction to serious illness is to deny the existence of the disease or its implications. In some ways it is a good thing to be able to put the disease to the back of your mind and get on with life, rather than dwelling on illness. Denial is only a bad thing if it stops you looking after yourself properly, such as, taking your medication, following dietary advice and attending regular clinic appointments. It might also prevent sensible future planning.

Anger - This is a very normal feeling and one, which is experienced by patients and the people close to them. You may find you lose your temper easily. You may feel that somebody must be to blame for what has happened, and be made to recognize it. Patients often turn anger against their Physician, who, they feel, could have prevented the kidney failure by earlier diagnosis. This is hardly ever true. It is a situation where nobody is to blame, so it is hard to find an outlet for the anger. Talking about how you feel will often help—try to remember there's always help and support available to you.

Fear - It is normal to be afraid, too. You will overcome your fear as you learn more about kidney failure and how you can control it. There may be very practical aspects to your fear—you may feel scared about telling family members or your employer. For more advice about how to tell other people about your kidney problems click here.

Guilt - Often family members or friends or the patient will ask "What did I do wrong?" or "What did I do to deserve this?" The answer is simple—nothing.

Patients often feel that they have let down those closest to them—their spouses and their children—by becoming ill. They fear being a burden and changing the lives of those around them. It is almost certainly true that the illness will affect those close to you, but the question you must ask yourself is "How would I have reacted if the situation had been the other way around? I would willingly and lovingly have supported my partner, and I would not have wanted them to feel bad about what had happened".

Acceptance - gradually, people come to accept reality a little at a time and begin to make progress towards successfully adapting to their condition. The more you learn about your illness and how to live with it, the sooner you will come to accept it.

"It took a long time to adjust. It was all such a shock. But, after an unsuccessful kidney transplant a year later, I realized I had to learn to cope with dialysis. It's now become a way of life." - Linda, Edinburgh

May 1, 2006