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Maddy Warren, who has no kidneys and relies on dialysis, is set to run the London Marathon for the second time. She made history with her first marathon completion in 2018.
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Maddy Warren, who has no kidneys, made history when she first completed the London Marathon in 2018 [Maddy Warren]
Anyone preparing to tackle the endeavour that is the London Marathon has lots to consider during their training.
But Maddy Warren has far more to manage than the average runner - and made history in 2018 with her first appearance in the race.
For the 42-year-old, from Southam in Warwickshire, has no kidneys, and is being kept alive entirely by dialysis.
Warren became the first woman without the organs to complete the marathon eight years ago. But, now she's decide to take on the challenge again.
"I did swear at the end of the last one that I would never do it again," she told BBC Radio CWR.
"But I was watching it last year and it's that atmosphere; people doing incredible things, raising so much money. It's such a great day out in London.
"So more fool me, I am giving it another go."
Unsurprisingly, Warren is raising money for Kidney Care UK, a charity she is also a trustee for that offers support to people living with kidney disease and their families.
"I've done lots of work with them over the years, especially supporting young adults with kidney disease because it can sadly strike people at any time, like it did with me as a teenager," she said.
"And there can be a perception that it's something that only really affects older people - but that's not the case. They are a brilliant charity and they've been very supportive."
Warren has so far raised £7,000 and has hailed her friends and family for being "extremely generous."
Maddy Warren faces significant challenges due to her lack of kidneys, relying entirely on dialysis for her survival.
Maddy Warren first completed the London Marathon in 2018, making history as a runner without kidneys.
Dialysis is crucial for Maddy Warren's survival, and she must manage her health carefully while training and participating in marathons.
Maddy Warren is from Southam in Warwickshire, England.

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The 42-year-old is raising money for Kidney Care UK, a charity supporting people with kidney disease, having already done a skydive for them [Maddy Warren]
Training for the marathon is a big endeavour for her, as she has to monitor her fluid, salt and electrolyte balance.
She also has to be careful in timing when she undertakes dialysis before the marathon, in order to let her blood pressure stabilise before going to the start line.
The physical toll on her body will also be significant, but Warren feels grateful she can take on the challenge.
"The physical challenge is that kidney failure and dialysis causes anaemia, it affects your bones, your energy," she said.
"That's just the side effects of missing two major organs.
"The training and the running is physically very very hard work for my body, but I actually feel incredibly lucky I'm well enough to try it, because that's very unusual on dialysis."
Maddy Warren was told as a teenager that her condition would limit her life expectancy [Maddy Warren]
Warren was just a teenager when she was told her life expectancy would be truncated by her losing both kidneys.
However, she has now "gone well past" predictions for her condition.
"At the time, it's devastating, especially as a teenager to learn that so early in life," she said.
"But the way I saw it then - however many years I have, I'm going to pack everything into them, so it taught me how to live life at 100 miles an hour.
"I've ended up being lucky enough to do some incredible things and chase opportunities that I think it made me very driven."
She says she has the best quality dialysis at home and does a lot more than the minimum treatment hours.
"It makes a lot of other things in life feel relatively easy, because I don't think I'll have to face anything harder than what I've already dealt with," she said.
"It will get me through on Sunday, for sure."
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