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Fatigue in advanced kidney disease.

Micol Artom1, Rona Moss-Morris1, Fergus Caskey2

  • 1Health Psychology Section, Psychology Department, Institute of Psychiatry, King's College London, London, UK.

Kidney International
|April 4, 2014
PubMed
Summary

Fatigue is a common and complex issue in advanced kidney disease, influenced by biological, psychological, and behavioral factors. Interventions like exercise and cognitive-behavioral therapy show promise for managing this multifactorial condition.

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Area of Science:

  • Nephrology
  • Psychology
  • Medical Research

Background:

  • Fatigue is highly prevalent in advanced kidney disease (42%-89%).
  • It is linked to adverse patient outcomes.
  • Understanding its complex origins is crucial for effective management.

Purpose of the Study:

  • To review factors associated with fatigue in advanced kidney disease.
  • To explore the multidimensional nature of fatigue.
  • To inform the development of targeted interventions.

Main Methods:

  • Literature review of studies on fatigue in advanced kidney disease.
  • Analysis of sociodemographic, biological, and psychological factors.
  • Examination of behavioral and cytokine associations (IL-6, CRP).

Main Results:

  • Fatigue is associated with psychological factors (depression, anxiety), behavioral factors (sleep, nutrition), and cytokines.
  • The relationship between depression and fatigue is moderate, indicating fatigue is not solely a distress symptom.
  • Nonpharmacological interventions, including physical exercise and cognitive-behavioral therapy, show promising results.

Conclusions:

  • Fatigue in advanced kidney disease is a multidimensional and multifactorial problem.
  • Treatment plans must address the complex etiology using pharmacological and nonpharmacological approaches.
  • Cognitive and behavioral strategies, proven in other populations, could be adapted for advanced kidney disease.