IgA nephropathy and fatigue: Causes and management
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Feeling worn out is common when you’re living with a chronic kidney disease (CKD), and fatigue can impact your life in ways that lab tests can’t capture. If you’re asking yourself, “Why am I tired with IgA nephropathy?” — or IgAN for short — the next steps are laboratory testing and tracking your symptoms to find specific causes.
Is fatigue a symptom of IgAN?
Low energy in IgAN is common, but it’s considered a nonspecific symptom, meaning it could also be caused by things that aren’t related to kidney disease. Poor sleep, low iron, anemia, a new medicine, thyroid trouble, or even a rough week are just a few of the things that can leave you fatigued.
Fatigue also doesn’t map neatly onto how advanced your kidney disease is. Some people with mild kidney findings feel exhausted, and some with more kidney damage feel fine.
What kidney-related fatigue can feel like
Not all fatigue feels the same. People often describe kidney disease tiredness as heaviness, not sleepiness.
The following table can help you identify possible causes for the symptoms you’re experiencing:
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| Possible cause | Common clues | What your care team may check |
|---|---|---|
| Anemia | Pale skin, breathlessness with mild activity, a fast heartbeat, feeling cold | Blood count and iron tests |
| Reduced kidney function | Swelling, itching, poor appetite, a metallic taste in the mouth | Kidney, blood, and urine tests |
| Sleep apnea or restless legs | Snoring, waking often, morning headaches, crawling leg feelings at night, daytime sleepiness | Sleep history, sleep study |
| Medicines | Tiredness that started or grew after a dosage change | A full medicine review |
| Low mood or anxiety | Loss of interest, tearfulness, tiredness that is worst in the morning | Mood screening |
| Infection | Fever, aches, tiredness that came on quickly | Physical exam, blood or urine tests |
| Other health conditions | Weight change, heat or cold intolerance, extra thirst | Thyroid, blood sugar, or other testing |
Anemia and iron deficiency
Anemia in kidney disease occurs when you don’t have enough red blood cells to carry sufficient oxygen to your body’s tissues. This leads to CKD fatigue. Many people associate anemia with low iron levels, but there are other potential causes that you should be aware of. For example, the kidneys produce a hormone called erythropoietin (EPO) that promotes red blood cell production from the bone marrow; reduced kidney function causes a drop in EPO levels and fewer red blood cells being produced.
Because iron deficiency is not the only cause of anemia, it’s important to never assume you need iron supplements. Ask your doctor to measure your iron levels and follow the recommendations of your healthcare team.
Treatment and management
Managing fatigue in kidney disease starts with identifying the causes. First, have a comprehensive discussion with your doctor about your fatigue. Depending on your clinical presentation and lab test results, your care team may adjust your meds, refer you for a sleep assessment, or suggest strategies to help you manage stress.
It can help to bring a list of specific questions to your appointment. There are some things you may want to ask:
- Could my hemoglobin or iron levels explain how I feel?
- Are any of my medicines likely to cause tiredness?
- Could my thyroid, blood sugar, or vitamin levels be related to what I’m experiencing?
- Would a sleep study be useful for me?
- What change in my energy would you want to hear about right away?
If your doctor has ruled out treatable causes for your fatigue, it may be time to incorporate lifestyle changes that support your well-being.
The 4 P’s of fatigue management
Energy conservation strategies can help you protect yourself from fatigue. Consider incorporating the 4 P’s:
- Pace your energy use and take frequent breaks.
- Prioritize a few tasks every day and focus your energy on them.
- Plan ahead so that physically demanding chores are spread out over time, and book short, frequent breaks into your schedule.
- Position your body to reduce fatigue — sit whenever possible, and think about how to make tasks more efficient.
A simple log can help you track patterns that contribute to fatigue. For two weeks, jot down the following:
- the date and how many hours you slept
- an energy rating from 1 to 10, morning and evening
- your main activities
- times that tiredness hit, and what you were doing
- meals, fluids, and any missed medication doses
- anything unusual, such as a cold or a medicine change
Bring this log to your next visit. Two weeks of notes often reveal more than a single conversation can.
Lifestyle changes that may help
Incorporating healthy lifestyle practices into your daily life can have a huge impact on your energy level.
Helpful habits include the following:
- Maintain adequate sleep (7-9 hours nightly) and good sleep habits by creating a cool, quiet sleeping environment and limiting screen time before bed.
- Follow the diet recommended by your physician, including fluid intake suggestions.
- Manage stress, which can contribute to fatigue.
- Stay physically active with a doctor-approved exercise plan.
Unless your doctor specifically recommends them, avoid over-the-counter fatigue supplements, as they might negatively affect your kidney function or interact with your medications.
When fatigue needs prompt medical assessment
Get immediate medical attention if fatigue occurs with any of the following:
- chest pain
- shortness of breath at rest or with light activity
- fainting or loss of consciousness
- black, tarry stools not explained by an iron supplement
- severe weakness, confusion, or trouble staying awake
- fever
Fatigue doesn’t have to control your life. The first step is recognizing that fatigue with IgAN has many possible causes. Work with your doctor to identify and minimize causes of your tiredness, and maintain pacing strategies and a healthy lifestyle to protect your energy levels.
IgA Nephropathy News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
