Fatigue across different chronic kidney disease populations: experiences and needs of patients.

Background: Fatigue is a common symptom of chronic kidney disease (CKD). Predominantly qualitative research among dialysis patients has contributed to our knowledge about CKD patients' fatigue experiences and perceptions. This nationwide survey study aimed to explore in different CKD populations: (i) patients' experienced fatigue burden, its impact on daily life, and presumed causes of fatigue; and (ii) patients' experiences and needs regarding support, discussion, and treatment of fatigue.

Methods: A survey assessing patients' fatigue experiences and needs was constructed in co-creation with the Dutch Kidney Patients Association. Descriptive statistics were used to summarize results and stratified by CKD populations [CKD without kidney replacement therapy (KRT), receiving dialysis, after kidney transplantation (KTx)], gender, and age.

Results: A high fatigue burden was found across all CKD populations (n = 414;144 CKD without KRT/39 dialysis/231 KTx): fatigue was often experienced (94.7%), present for >6 months (90.3%), in the top three most burdensome symptoms (86.3%), and presumed causes were multifactorial. Younger patients were limited in more life domains than elderly. Some patients (32.1%) never or rarely discussed fatigue with their physician, did not receive treatment (67.8%), or felt the advice/treatment(s) insufficiently managed their fatigue (58.6%). More women and 18-50-year-old patients reported insufficient social support. Patients desired acknowledgement and more information about treatments and coping strategies for (consequences of) fatigue.

Conclusion: High fatigue burdens and insufficient support are experienced across all CKD populations, gender, and age groups. To address patients' unfulfilled needs, it is important to structurally measure and discuss fatigue in routine nephrology care, strengthen social support, and provide patient-centred multidisciplinary symptom management.