Fresenius Nurse Practice Test 2026 - Free Practice Questions and Study Guide for Fresenius Nurses

Fatigue and weakness are the most common symptoms in end-stage renal disease because the kidneys fail to perform two key jobs that keep energy levels stable: making erythropoietin to drive red blood cell production, and clearing waste products from the blood. When erythropoietin drops, anemia develops, reducing oxygen delivery to tissues and leaving you with less energy and more easy exhaustion. At the same time, buildup of toxins (uremia) contributes to a general sense of malaise, lethargy, and diminished concentration. Dialysis helps remove some toxins and excess fluid, which can improve energy, but without addressing the anemia, fatigue tends to persist. While weight gain from fluid retention, numbness from neuropathy, or headaches can occur in ESRD, they are less consistently reported than fatigue, making fatigue or weakness due to anemia and toxin buildup the best, most typical symptom to recognize.