Do you feel tired while living with chronic kidney disease (CKD) like C3 glomerulopathy (C3G)? You’re not alone. About 70 percent of people with chronic kidney disease report experiencing fatigue, and up to 25 percent say it can be severe.

If chronic kidney disease is making you feel low on energy, it helps to understand why. You and your doctor can then find ways to manage fatigue that fit your needs and lifestyle.

Reasons Kidney Disease Can Cause Fatigue

There are several reasons why chronic kidney disease can lead to tiredness, but not all these causes of fatigue may apply to you. Talk with your doctor to figure out the best way to manage your symptoms of fatigue.

When your kidneys aren’t doing their job well, they can’t filter toxins out of your blood the way they should. These toxins can build up in your body, leading to tiredness. As your kidney function gets worse, you may feel more and more tired.

Kidneys also make a hormone called erythropoietin, which helps produce red blood cells. Some types of CKD can lead to anemia, a condition in which your body doesn’t have enough red blood cells to carry oxygen to your muscles and organs. Anemia can make you feel constantly tired and low on energy.

Chronic kidney disease can also cause imbalances in electrolytes — minerals that help your body function. Hyponatremia (low sodium in the blood) can lead to fatigue, while acidosis (too much acid) and hyperphosphatemia (high phosphorus) can weaken muscles and cause fatigue. Ask your doctor if CKD might be causing these issues and contributing to your fatigue.

If you’re on dialysis, you may also feel tired and drained after treatments. This effect may go away as your body adjusts to the procedure, but some people continue to experience fatigue after dialysis.

Not getting enough quality sleep can also leave you feeling tired during the day. Sleep apnea, restless legs syndrome, nighttime itching, anxiety, or depression can make it hard to rest properly.

Fatigue may become more severe as kidney function declines, especially in end-stage kidney disease. If you’re feeling more tired over time, let your doctor know.

C3 Glomerulopathy and Fatigue

C3 glomerulopathy is known for causing fatigue. This kidney disease is rare, but the fatigue, swelling, and mental health issues it causes are very real for the people who live with it. Researchers agree that there’s an urgent need to find better C3G treatments because these symptoms can greatly affect quality of life.

C3G causes fatigue because the kidneys can’t properly remove waste products. As waste builds up, it can affect brain function, often resulting in fatigue or trouble concentrating.

Lifestyle Changes To Manage Fatigue With Kidney Disease

You can take several steps to help reduce fatigue with kidney disease.

Add Physical Activity

It might seem surprising, but getting regular exercise may help manage fatigue from chronic kidney diseases like C3G. The key is to find what works best for you. You might choose to be active only on days when you’re not so fatigued or plan physical activity for the time of day when you feel your best. Your healthcare team can help you create a plan that meets your needs.

Manage Your Fluids

Make sure you’re drinking plenty of water each day. Staying hydrated helps your kidneys remove as much waste as possible, which may reduce fatigue. Proper hydration also supports healthy blood flow so that your kidneys get plenty of nutrients.

However, it's important to talk to your nephrologist (specialist in treating kidney diseases) about how much fluid is right for you. If you’re on dialysis, follow their guidance about fluids. Drinking too much may lead to longer or more frequent dialysis treatments, which can increase fatigue.

Eat To Support Your Kidneys

Eating the right foods can help balance electrolytes, which may reduce fatigue. After a CKD diagnosis, such as C3G, your doctor will likely provide dietary guidelines. You may need to limit phosphorus, sodium, and potassium while making sure you get enough calories and healthy fats, as well as the right amount of protein. A registered dietitian can help you figure out an eating plan that supports your health and energy levels.

Medical Treatments To Reduce Fatigue With Kidney Disease

Your doctor may suggest certain medications or supplements to help manage fatigue with kidney disease.

Treating Anemia

If your red blood cell count is low, your doctor might prescribe erythropoiesis-stimulating agents (ESAs). These medications help your body make more erythropoietin, a hormone that tells your bone marrow to produce red blood cells. Although ESAs can help with anemia, they have serious side effects, so doctors use them cautiously.

Iron supplements may also be recommended, especially if you have iron-deficiency anemia. Although there’s not much research on whether iron supplements help fatigue, this mineral helps make healthy red blood cells and may lower your risk of cardiovascular (heart and blood vessel) disease. Your doctor might also suggest taking vitamin B12 and folic acid supplements, which help support red blood cell production.

Balancing Electrolytes

If an electrolyte imbalance causes your blood to become too acidic, your doctor may have you take sodium bicarbonate (baking soda) to help restore balance. Keeping electrolytes stable may reduce fatigue.

Improving Sleep

If poor sleep is making you tired, your doctor may recommend treatments based on the cause. If you have sleep apnea, you may be advised to lose weight, quit smoking, or use continuous positive airway pressure (CPAP) therapy. For restless legs syndrome, you may need certain supplements, medications, or lifestyle changes to relieve discomfort and improve sleep.

Managing Mental Health

If anxiety or depression is contributing to your fatigue, your doctor may refer you to a counselor or therapist. Therapy can help you reduce your stress, process emotions, and improve sleep quality. After a few sessions, you may notice that you feel less fatigued.

Sometimes, doctors prescribe medication for depression or anxiety. Most of these drugs haven’t been consistently shown to reduce fatigue in CKD, but research is ongoing to find options that might help.

Tell Your Doctor About Your Fatigue

If you have chronic renal (kidney) disease and are feeling more tired than usual — or if fatigue has always been an issue but you haven’t mentioned it to your healthcare provider — it’s important to speak up. Your doctor needs to know what symptoms you’re experiencing, how severe they are, and how they affect your daily well-being.

By working with your nephrologist, you can develop a treatment plan that fits your needs. This may include both medical and lifestyle changes. Over time, you’ll learn what works best to help you manage fatigue and feel better.

Talk With Others Who Understand

On MyKidneyDiseaseTeam, the social network for people living with rare kidney disease and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with kidney disease.

Do you deal with fatigue or tiredness related to kidney disease? What do you do to improve your quality of life? Share your experience in the comments below, or start a conversation by posting on your Activities page.