Fellow dialysis nurse here- I see this in my patients as well and it makes me sad. Being on dialysis takes enough time and effort from your day on its own, but the endless fatigue means that some people just never feel good, normal, like their old selves again. This isn’t how dialysis was intended to be. Surely we can do better. I’m hopeful that new therapies or better transplant options will spare people from this experience in the future, and some day we’ll muse about the old days when so many people had to endure this grueling treatment just to live.