For people with chronic kidney disease (CKD), fatigue is a common symptom of dialysis treatment. Excessive fatigue may lead to a sedentary lifestyle, obesity, use of sleeping medications, and a higher burden of medical conditions. 

While research has shown how dialysis may lead to fatigue for dialysis patients, less is known about fatigue among non-dialysis patients. A 2019 study investigated the prevalence of fatigue among CKD patients who are not on dialysis—with resounding results that showed fatigue affected other aspects of patients’ lives, too, including unemployment.*

What they did

The study recruited 266 participants who were all non-dialysis patients and were between stage 2 and stage 5 CKD. The average patient age was 64.4 years. Each participant completed three different questionnaires on fatigue and potential associations. 

The questionnaires included:

• Quick Inventory of Depression Symptomatology-Self Report (QIDS-SR16)
• Beck Depression Inventory-I (BDI-I)
• 12-Item Short Form Survey (SF-12)

In addition to the questionnaires, researchers also monitored each patient’s health status over the next 12 months and tracked progression to hospitalization, dialysis, and/or death.

What they found

The researchers found fatigue to be a common symptom of dialysis patients, as approximately 70% of participants reported fatigue. 

Factors associated with fatigue included: 

• Unemployment
• Comorbidities (related medical conditions) 
• Use of antidepressant medications
• Lower hemoglobin levels 
• Substance abuse 
• Progression to hospitalization, dialysis, and death

What it means

The findings show fatigue may represent more severe underlying chronic illness or unfavorable health status, which may be a sign of a future adverse event. Researchers encourage health professionals to investigate thoroughly for causes among CKD patients complaining of fatigue. 

Due to fatigue being common among nondialysis CKD patients, more research is imperative to fully address fatigue and associated factors among this population. 

*Gregg, L. P., Jain, N., Carmody, T., Minhajuddin, A. T., et al. (2019). Fatigue in Nondialysis Chronic Kidney Disease: Correlates and Association with Kidney Outcomes. American Journal of Nephrology. https://www.karger.com/Article/FullText/500668