Prevalence and Risk Factors of Fatigue in Adults with Stage 3 and 4 CKD: Findings from NHANES 2007-2012

Background: Fatigue is a devastating symptom experienced by adults with chronic kidney disease (CKD), but less is known about the prevalence of fatigue and factors associated with fatigue in a general population of adults with CKD. Therefore, we examined the prevalence of fatigue and identified factors associated with fatigue amongst a national cohort of US adults with CKD. Methods: We utilized cross-sectional data from 1,079 adults from the National Health and Nutrition Examination Survey (NHANES) 2007-2012 and included participants aged 18 and over with CKD Stage 3 and 4 (eGFR between 15 and 60 ml/min/1.73m 2 ) who had available data evaluating fatigue. Unadjusted and adjusted logistic regression models were used to evaluate the odds of having fatigue in the context of physiological, sociodemographic, psychological, and behavioral factors. Results: We estimated that 48% of those with CKD had fatigue. Among the risk factors examined, the factors with the strongest evidence of association in multivariable analyses were female sex (OR 1.49, 95% CI: 1.02, 2.17), pain (OR 2.49, 95% CI: 1.57, 3.93), poor mental health (OR 1.97, 95% CI: 1.05, 3.72), anxiety (OR 1.95, 95% CI: 1.14, 3.34), and depressive symptoms (OR 2.58, 95% CI: 1.17, 5.66). Conclusions: Fatigue is a common symptom experienced by adults with CKD in the US. Physiological, sociodemographic, psychological, and behavioral factors are associated with fatigue, with psychological factors being most strongly associated. Future work is needed to identify interventions to mitigate fatigue and risk factors for fatigue in adults with CKD.