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. 2025 Jan 3;18(1):sfae433.
doi: 10.1093/ckj/sfae433. eCollection 2025 Jan.

Iron management and exercise training in individuals with chronic kidney disease: lived experiences

Courtney J Lightfoot  1   2 , Sharlene A Greenwood  3   4 , Elham Asgari  5 , Debasish Banerjee  6 , Sunil Bhandari  7 , James O Burton  8   9 , Philip A Kalra  10 , Kieran McCafferty  11 , Benjamin A Oliveira  4 , Chante Reid  3 , Pauline A Swift  12 , David C Wheeler  13 , Thomas J Wilkinson  1   2   14 , Kate Bramham  3   4 , Alice C Smith  1   2
Affiliations

Iron management and exercise training in individuals with chronic kidney disease: lived experiences

Courtney J Lightfoot et al. Clin Kidney J. .

Abstract

Background: Non-anaemic iron deficiency is highly prevalent in people living with chronic kidney disease (CKD) but is underdiagnosed and undertreated, especially in earlier stages of CKD. A multicentre trial assessing the effect of intravenous iron supplementation in iron-deficiency but not anaemic people with CKD included a qualitative sub-study that aimed to explore the patient experience and psychosocial impact of living with CKD and iron deficiency, and the experience of the therapeutic intervention (intravenous iron and exercise).

Methods: Semi-structured interviews were conducted with 23 trial participants blinded to treatment. Topics explored included experiences of living with CKD and iron deficiency, symptoms, social and leisure activities, quality of life, and participants' views and experiences of receiving the therapeutic intervention. Thematic analysis was used to identify and report themes.

Results: Six overarching themes were identified: lack of awareness of iron deficiency; overwhelming feelings of tiredness; feeling limited; balancing emotions; perceptions and experiences of therapeutic treatment received; and impact of trial participation on life participation. Trial participation, specifically the exercise training, was perceived to be beneficial, with improvements in life participation and psychological wellbeing experienced. However, there were no clear differences between treatment groups, with mixed perceptions about which therapeutic treatment was received.

Conclusions: The impact of tiredness on individuals with CKD is profound and can result in reduced vitality, impaired ability to engage in life activities and emotional conflict. Improved communication and support about psychosocial impact and management of symptoms, particularly fatigue, for people with CKD may be required, alongside effective therapeutic interventions, to improve symptom management and quality of life.

Keywords: chronic kidney disease; exercise; fatigue; iron; quality of life.

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Conflict of interest statement

S.B. was a previous Trustee for Kidney Research UK and has served on the advisory board of CSL Vifor. P.A.K. has served on advisory boards and lectured for CSL Vifor, and Salford Royal has received research funding from this company. D.C.W. has received honoraria from CSL Vifor. D.B. has lectured for CSL Vifor. All other authors declare that they have no competing interests.

Figures

Figure 1:
Figure 1:
Schematic showing flow of participants through I&M trial and location of interviews during trial.
See this image and copyright information in PMC

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