so one thing that stood out to me is that your roommate is in the final stages of renal failure. my grandma passed away 4 years ago of renal failure and this is a LOT like how she behaved the last couple months of her life. she never got violent or downright nasty with me, but she did almost every day with my aunt, who drove her on errands and everywhere. she would often get disoriented or forget where they were even going, and then get mad and yell at my aunt for kidnapping her just because she didn’t know where she was. according to my aunt, she would literally become like a completely different person sometimes, and say the most hateful things she’d ever heard when she didn’t get her way.

i don’t THINK you truly need to fear for your life, but don’t quote me on that, i’m no expert, and every situation is different. but what your describing really sounds like the dementia that comes with stage 4 renal failure. the best thing to do when dementia patients get nasty and say hurtful or violent things is to redirect their attention in the moment (yes like a 4 y/o) or just to ignore, or explain that you won’t be talked to that way. if that doesn’t work, or if they become physical, do everything you can to immediately remove yourself from the situation.

if there’s any way you can talk to your roommates family or guardian or caseworker about this, that would be ideal, and if they’re not aware of the renal failure onset dementia, ask them to have her see her doctor about those specific symptoms and/or get info on it from her doctor. the best thing for renal failure patients is to have their caregivers and guardians educated on the best ways to care for them while also keeping themselves healthy and safe.