Exercise and Kidney Function in Care of Older Adults
Management of Kidney Disease with Sickle Cell Disease
Experiences and Needs of Patients with Chronic Kidney Disease Regarding Fatigue
Experiences and Needs of Patients with Chronic Kidney Disease Regarding Fatigue
Main Message:
Fatigue is a highly prevalent, burdensome, and persistent symptom among patients with chronic kidney disease (CKD), including those on dialysis and after kidney transplantation (KTx). Despite its significant impact on daily life, fatigue is under-discussed and insufficiently managed in routine nephrology care. There is a clear need for more patient-centered, multidisciplinary approaches that include psychosocial support and better communication about fatigue.
Key Points:
- Most patients experience fatigue across physical, mental, social, and emotional domains, with younger patients reporting greater mental and social fatigue and higher daily life impact.
- A large proportion of patients rarely discuss fatigue with their physicians, often due to assumptions it is a normal part of CKD or lack of physician attention.
- Advice and treatments provided (lifestyle changes, medication adjustment, paramedical care, vitamin regulation) often have limited perceived effectiveness.
- About half of the patients report insufficient social support for fatigue, especially women and younger patients.
- Patients want their fatigue to be acknowledged, want more support from healthcare professionals and their social network, and need better information about coping and treatment options.
- Fatigue has many causes, so effective treatment needs to combine medical and non-medical approaches tailored to each individual.
- Patient-reported outcome measures (PROMs) are tools that allow patients to report their fatigue and can improve care but are not yet routinely used in kidney clinics.
- Psychosocial and educational interventions, shown effective in other chronic diseases, should be incorporated into fatigue management for CKD.
- Differences between CKD populations, genders, and ages exist but are generally small; however, personalized treatment remains important.
Challenges & Considerations:
- The survey sample may not fully represent the broader CKD population due to digital format and demographic skew (younger, more educated, more women).
- Lack of detailed clinical data ( kidney function, dialysis vintage) limits context on fatigue severity.
- There is a need to validate symptom-specific assessment tools for fatigue.
- Kidney disease treatment guidelines mostly focus on medical issues like anemia and don’t fully address the complex causes of fatigue.
- It’s challenging to include fatigue assessments and team-based approaches in everyday kidney care.
Conclusion:
Fatigue is a serious but often overlooked problem for people with CKD, significantly reducing quality of life. To improve care, healthcare providers need to regularly measure fatigue, offer a mix of treatments including emotional support, and focus on patient-centered care. Future research should develop better treatments and update guidelines to meet the needs of patients experiencing fatigue.
References:
Schade van Westrum E, Hoogeveen EK, Broekman BFP, et al. Fatigue across different chronic kidney disease populations: experiences and needs of patients. Clin Kidney J. 2025;18(5):sfaf118. Published 2025 Apr 18. doi:10.1093/ckj/sfaf118