Which of the following is a non-hemic symptom that affects quality of life in advanced CKD?

• A. Hematuria
• B. Edema
• C. Fatigue
• D. Hypertension

Answer: (C)

Fatigue is the non-blood-related symptom that most reduces quality of life in advanced CKD. It stems from multiple CKD-related factors, especially anemia due to decreased erythropoietin production, plus accumulation of uremic toxins, metabolic acidosis, sleep disturbances, and inflammation. This persistent lack of energy directly limits daily activities, work, and mood, making it a core factor in diminished QoL. Hematuria involves blood in the urine, so it’s a blood-related (hemic) finding. Edema is fluid overload a sign rather than the subjective experience of fatigue, and hypertension is a common condition rather than a symptom driving QoL in the same direct, patient-reported way.