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Anemia and other contributing factors are common causes of fatigue in chronic kidney disease (CKD). Healthy lifestyle habits and taking steps to meet your nutritional needs can help.

If you have chronic kidney disease (CKD), you might tire easily while doing housework or feel sleepy during the day. This overly tired feeling may begin to affect your work, personal life, and general well-being.

Fatigue is a common symptom of CKD. Causes include chronic inflammation and other health conditions, such as anemia. Fatigue can also be a side effect of certain medications to treat CKD.

Following your treatment plans for CKD and any other health conditions you may have is important for managing fatigue and related symptoms.

People with CKD often report feeling very tired or having a lack of energy that lasts a long time. This feeling often doesn’t go away, even after getting enough rest or a full night’s sleep.

According to earlier studies cited in a 2021 research review, 20% to 91% of people with CKD experience fatigue, and among them, 5% to 24% experience severe fatigue. The chances of experiencing fatigue increase as CKD progresses to advanced or severe stages.

Your kidneys produce the hormone erythropoietin, which tells your body to make more red blood cells. When you have CKD, you may have low levels of erythropoietin, which can cause low levels of red blood cells, leading to anemia.

Anemia is one of the potential causes of fatigue in CKD.

Other factors may also contribute to fatigue in CKD, including:

  • changes in circulation, metabolism, and blood chemistry
  • loss of muscle mass and strength
  • chronic inflammation
  • nutrient deficiencies
  • treatment side effects

Additionally, people with CKD may have an increased risk of some other health conditions that can contribute to fatigue.

Regular checkups with a doctor are important for monitoring and managing CKD. Your treatment may change as your condition changes or new treatments become available.

People with CKD often have other health conditions, including:

  • cardiovascular disease
  • diabetes
  • depression
  • anxiety disorders

These health conditions may contribute to fatigue.

You can talk with a doctor to learn how to reduce the chances of developing health conditions related to CKD. They may recommend medication, lifestyle changes, or other strategies.

If you notice changes in your energy levels or overall health, let the doctor know. They can help you determine whether the changes are caused by CKD or another condition that may also need treatment.

Also, let the healthcare team know if you think you’re experiencing side effects from treatment. Some medications and procedures may cause fatigue as a side effect.

Getting enough sleep, exercising regularly, and managing stress may help support your health and reduce fatigue.

Taking steps to conserve or budget your energy may also help you manage fatigue and related symptoms like daytime sleepiness.

Sleep

Getting enough sleep is important for feeling energized and focused.

The Centers for Disease Control and Prevention (CDC) advises adults to get at least 7 hours of sleep per night. Some people with chronic health conditions may need more sleep.

Let a doctor know if you’re finding it hard to sleep or if you feel tired even after getting the recommended amount of sleep. They may order tests or refer you to a sleep specialist to find out whether you have a sleep disorder that needs other treatment approaches.

The healthcare team may also ask about your sleep environment and routine.

The following sleep hygiene practices may help improve your sleep:

  • Go to sleep and wake up at the same time each day.
  • Avoid consuming caffeine, nicotine, alcohol, and large meals close to bedtime.
  • Keep your bedroom dark, quiet, and at a comfortable temperature whenever possible.
  • Remove smartphones, computers, and other electronic devices from your bedroom.
  • Get some exercise during the day.

You can talk with a doctor to learn more strategies for improving your sleep.

Exercise

A 2022 review reports that multiple studies have found that regular exercise may improve fatigue in people with CKD.

Exercising regularly also has other physical and mental health benefits.

The CDC encourages adults to get at least 150 minutes of moderate-intensity aerobic exercise per week (or 75 minutes of high intensity exercise) and to do muscle-strengthening activities at least 2 days per week.

Examples of moderate-intensity aerobic exercise include:

  • brisk walking
  • bike riding
  • water aerobics
  • mowing the lawn

Examples of muscle-strengthening activities include:

  • weightlifting
  • resistance band exercises
  • bodyweight exercises, such as pushups and situps
  • certain types of yoga
  • heavy gardening

Talk with a doctor before you change your exercise routine. Your exercise needs and limitations may vary depending on your specific condition.

A doctor may refer you to a physical therapist, occupational therapist, or other specialist who can help you develop a safe and sustainable exercise plan.

Stress management

Living with CKD can be stressful, and stress can increase fatigue.

Getting enough sleep, exercising regularly, and practicing other healthy habits may help limit the effects of stress on your physical and mental health.

You might also find it helpful to:

  • spend time with loved ones
  • make time for activities you enjoy
  • explore your feelings through art or journaling
  • practice relaxation techniques such as:
    • deep breathing
    • guided meditation
    • yoga, tai chi, or other mind-body exercises

Let a doctor know if you’re experiencing frequent stress or other mental health challenges. They may refer you to a mental health specialist for support or recommend other treatments.

Energy conservation

Severe fatigue may make it harder to complete your usual tasks at work or at home.

You might find it helpful to:

  • prioritize completing the most important tasks at times of day when you feel most energetic
  • take regular breaks during and between challenging tasks
  • limit naps during the day

Consider whether there are certain responsibilities or commitments you can turn down or outsource to someone else.

You might also find it helpful to meet with an occupational therapist who can help you develop strategies for managing fatigue at work or at home.

For example, they may recommend changing the layout of your workspace to increase your comfort or limit the physical challenges of completing certain tasks.

They may also recommend assistive devices or other tools to help you complete certain activities more easily or efficiently.

Eating a balanced diet, staying hydrated, and addressing nutritional deficiencies may help:

  • provide iron and B vitamins, which are essential for red blood cell production
  • maintain muscle mass
  • lower your risk of certain complications from CKD
  • reduce your risk of certain health conditions related to CKD

Taking steps to meet your nutritional needs may also help limit fatigue.

Balanced diet

A balanced, nutrient-rich diet typically includes a wide variety of:

  • fruits and vegetables
  • whole grains, nuts, and seeds
  • legumes, such as beans and lentils
  • lean proteins, such as seafood and lean poultry

Your specific nutritional needs may vary, depending on the stage of your CKD and whether you have other health conditions, such as cardiovascular disease or diabetes.

CKD can cause certain nutrients and waste products to build up in your blood, which may worsen symptoms or lead to complications.

Your doctor may advise you to manage this risk by limiting one or more of the following nutrients in your diet:

  • protein
  • sodium (salt)
  • potassium
  • phosphorous
  • calcium

It’s crucial to get enough of these nutrients, but not too much.

A doctor may refer you to a registered dietitian who can help you learn more about your nutritional needs and how to meet them.

Hydration

Dehydration can contribute to fatigue and other health challenges. Drinking enough fluid is important for preventing dehydration.

But if you have advanced CKD, consuming too much fluid may cause too much water to build up in your blood. This can lead to high blood pressure and electrolyte imbalances.

A doctor may advise you to monitor and limit the amount of fluid you consume, especially if you have advanced CKD or kidney failure.

Talk with a doctor or a dietitian to learn how much fluid to consume daily.

Nutritional deficiencies

CKD may cause loss of appetite or require changes to your diet that make it harder to meet your nutritional needs. This can potentially lead to nutrient deficiencies, which happen when the levels of certain vitamins, minerals, or other nutrients are too low in your body.

Other health conditions or lifestyle habits can also contribute to nutritional deficiencies.

Certain deficiencies may contribute to fatigue. For example, low iron can make anemia worse and increase fatigue.

Your doctor may order blood tests to check your nutrient levels. They may recommend changes to your diet or prescribe nutritional supplements if you have a deficiency.

But don’t start taking any supplements without talking with your doctor first. Certain supplements may interact with medications or may not be safe for people with CKD.

The challenges of managing CKD, particularly severe fatigue, may negatively affect your mental health or emotional well-being. Reaching out for support from others may help.

You might find it helpful to do one or more of the following:

  • Spend time with loved ones and talk with them about your experiences.
  • Join a support group or peer mentorship program for people with CKD.
  • Connect with a mental health specialist who has experience supporting people with CKD or other chronic health conditions.

Let a doctor know if you’re experiencing mental health challenges that are negatively affecting your daily life.

They may refer you to a mental health specialist for cognitive behavioral therapy (CBT) or other forms of counseling. CBT focuses on changing unhelpful patterns of thinking and behavior.

A 2023 study assessed a CBT program for people with kidney disease who were receiving hemodialysis. Some but not all participants noticed improvements in their fatigue levels.

Additionally, a 2017 review found that CBT and other psychosocial interventions may help improve fatigue in people with end stage kidney disease.

Let a doctor know if you’re experiencing fatigue or other symptoms. They can help you find out whether CKD or another health condition may be causing your symptoms.

Depending on the cause of your symptoms, a doctor may recommend changes to your treatment plan or lifestyle habits. They may also refer you to a specialist for support.

Also, talk with a doctor if you have questions or concerns about your current treatment. They can help you learn about the potential benefits and risks of different treatments.

Many people with CKD experience fatigue, which may sometimes be severe. Other health conditions and lifestyle factors can also contribute to fatigue.

Let a doctor know if you’re experiencing fatigue or daytime sleepiness. They can help you identify the cause and find strategies to manage it. They may recommend changes to your treatment plan or lifestyle habits.

Getting enough sleep, exercising regularly, and meeting your nutritional needs are important for maintaining your energy levels and promoting overall health.

Managing stress and reaching out to others for mental health or emotional support may also help you manage the challenges of CKD, including fatigue.