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About Renal/Kidney Disease
Kidney diseases are diseases of the kidney substance that alter the structure and function of the kidney. There are many diseases of the kidneys such as glomerulonephritis, pylonephritis, polycystic kidney, and lupus nephritis. The treatment and potential for recovery depends on the type of disease. Kidney diseases can lead to kidney failure.
When an individual has mild kidney failure, dialysis or renal transplant is not required. However, the individual may need to take certain medications and abide by dietary restrictions. Dialysis is needed when the body alone can no longer remove enough waste products to sustain life.There are two forms of dialysis: hemodialysis and peritoneal dialysis. Hemodialysis is a process where excess waste products and water are removed from the patient's blood, which is drawn through a special created vein in the forearm, into a dialysis solution. Hemodialysis requires the use of a machine and one dialysis session takes about four hours to complete, usually three times a week. Peritoneal dialysis is performed by introducing dialysis solution into the peritoneal (abdominal) cavity through a catheter. Waste products and excess water from the body are passed through a natural membrane lining of the peritoneal cavity, and the solution can be drained out of the abdomen into a bag and be thrown away. Peritoneal dialysis usually involves four exchanges per day. Accommodations for individuals with kidney disease differ dramatically from one person to another.
Renal/Kidney Disease and the Americans with Disabilities Act
The ADA does not contain a list of medical conditions that constitute disabilities. Instead, the ADA has a general definition of disability that each person must meet. A person has a disability if he/she has a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment, or is regarded as having an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).
Accommodating Employees with Renal/Kidney Disease
People with limitations from renal/kidney disease may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people who are aging will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.
Questions to Consider:
- What limitations is the employee experiencing?
- How do these limitations affect the employee and the employee’s job performance?
- What specific job tasks are problematic as a result of these limitations?
- What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
- Has the employee been consulted regarding possible accommodations?
- Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
- Do supervisory personnel and employees need training?
Situations and Solutions:
A retail sales associate with diabetes developed complications that affected the functioning of her kidneys.
She required hemodialysis three times a week. Hemodialysis requires adhering to a fixed schedule. The employee requested a transfer to a store closer to the dialysis center as an accommodation under the ADA, and applied leave under the FMLA, when needed, to receive dialysis.
A financial advisor had renal failure which required dialysis treatment three times a week.
The employer granted a modified schedule so the employee could work around his medical appointments. The employee was able to work before and after dialysis, so work goals were still achieved.
A cashier at a large retailer had kidney disease.
The company had a no food or drink policy, which prohibited employees from having food or drink on the sales floor. The employee had dietary needs that required him to drink during his shift. The employer modified its policy and permitted the employee to drink at his workstation. This enabled the employee to continue working while maintaining his health.
A tax preparer with renal disease had trouble getting to work on time due to toileting needs.
They requested and was permitted telework to eliminate the need to commute daily. This enabled the employee to meet his toileting needs, but also perform the job effectively.
An employment counselor had a kidney stone, which required monitoring from a healthcare provider.
The employer granted ADA leave as an accommodation so the employee could seek medical treatment. Once recovered, the employee was able to return to work full duty.
A warehouse worker returned to work following a kidney transplant.
The employee had lifting restrictions and follow up medical appointments. The employer explored lifting devices on JAN's website, which they then provided along with leave time for the medical appointments. This enabled the company to retain a valued employee.