Dialysis is a medical treatment for patients with kidney failure that manually flushes deadly solutes and toxins from the bloodstream in place of the urinary system completing the same function. Blood is pumped out of the body and into a machine called a dialyzer that filters unwanted substances out, before being pumped back into the body. Robert’s chronic kidney failure requires him to receive dialysis three times a week for several hours, with the risk of death if he is unable to do so. This massive time commitment, as well as the immense physical strain the treatment takes, are highlighted by Abraham as aspects of healthcare that are largely manageable for wealthy and financially stable patients but unavoidably debilitating for patients who come from low-income backgrounds.

The blood vessels in the kidneys are called the glomeruli, and they filter urine out of blood. Glomerulosclerosis is scarring in these blood vessels. It can be caused by diabetes or other kidney problems. Dialysis or a kidney transplant can be necessary in more severe cases. Robert has this condition, as Abraham highlights in the text.