Dialysis is a medical procedure that removes waste products and excess fluid from the blood when the kidneys are no longer able to perform these functions adequately. This life-sustaining treatment for kidney failure often causes fatigue, a common and challenging symptom that can noticeably affect daily life.
Why Fatigue Occurs During Dialysis
The dialysis procedure itself can directly contribute to tiredness due to several physiological changes. During a dialysis session, significant fluid and electrolyte shifts occur as waste products and excess water are filtered from the blood. This rapid removal of fluid can lead to a drop in blood pressure (intradialytic hypotension), which can result in dizziness and fatigue.
The body also expends energy during the treatment process. Hemodialysis patients have higher resting energy expenditure levels that increase during the procedure. This elevated energy use can leave individuals feeling drained. Additionally, the process of removing toxins and the stress it places on the body may temporarily affect red blood cell levels, contributing to a “washed out” feeling that can last for hours or even longer after a session.
Other Factors Contributing to Tiredness in Kidney Disease
Beyond the direct effects of dialysis, several systemic issues related to chronic kidney disease (CKD) can cause persistent tiredness. Anemia is a common complication in CKD; damaged kidneys produce less erythropoietin, a hormone essential for red blood cell production, leading to low red blood cell counts and subsequent fatigue.
Between dialysis sessions, waste products and toxins can accumulate (uremia), leading to profound fatigue, weakness, and reduced mental clarity. Sleep disturbances are also prevalent in CKD, often due to restless legs syndrome. Chronic inflammation and nutritional deficiencies, common due to dietary restrictions and altered appetite, can deplete energy levels. The psychological burden of managing kidney disease also contributes to exhaustion, anxiety, and depression.
Managing Tiredness on Dialysis
Managing fatigue involves a comprehensive approach, often requiring adjustments to lifestyle and treatment plans in consultation with the healthcare team. Optimizing the dialysis schedule, such as choosing afternoon or evening sessions, can help minimize post-dialysis tiredness. Adhering to prescribed dietary guidelines, including focusing on protein-rich foods and managing fluid intake, supports energy levels and prevents fluid imbalances.
Regular, moderate physical activity, such as walking or cycling, can significantly improve energy levels and overall well-being. Improving sleep hygiene through consistent bedtime routines and creating a calming sleep environment is important for better rest. Addressing anemia with iron supplements or erythropoiesis-stimulating agents can reduce fatigue. Seeking emotional support through counseling or support groups also helps manage the psychological aspects of living with CKD.
When to Seek Medical Advice
While fatigue is common for individuals on dialysis, certain changes warrant immediate medical attention. A sudden worsening of tiredness, or new and severe symptoms like fever, chest pain, or unexplained weight loss, should be reported to the healthcare team. These could indicate an underlying infection or other serious health complications.
Persistent fatigue that significantly impacts daily life, despite management efforts, requires discussion with a doctor. This includes fatigue interfering with work, social activities, or personal care. Symptoms of depression, such as prolonged sadness, loss of interest, or changes in appetite and sleep, should also be shared with the nephrology team, as these can be treated and contribute to fatigue. Open communication ensures fatigue is adequately assessed and managed.