Care Beyond the Clinic: Maintaining Life on Kidney Dialysis in Aging Japan

Care for kidney failure in the context of rapid aging taxes society, the state, and the individual patient. Kidney dialysis is the predominant form of care for end-stage renal disease in Japan. In this article I explore how dialysis proficiency and dominance in Japan is made possible by a culture of “high touch” and paternalistic medicine, patient endurance, medicalization, socialization, and gendered care. This culture of management is both generous and demanding, making widespread dialysis possible while making extreme demands on patients, society, and the state in extreme ways. The article explores the fine lines between care and exhaustion.