Chan, Winnie, Bosch, Jos A, Jones, David et al. · Transplantation · 2013 · DOI
This study looked at tiredness in people who have received kidney transplants and are doing well medically. Researchers found that nearly 6 out of 10 kidney transplant patients experience significant fatigue that affects their daily life and quality of life, yet most doctors weren't documenting this problem in their medical records. The fatigue levels were similar to those seen in chronic fatigue syndrome, and it was linked to factors like inflammation, kidney function decline, poor sleep, anxiety, and depression.
ME/CFS patients and researchers often encounter unrecognized fatigue in comorbid conditions; this study demonstrates that profound, multi-dimensional fatigue can occur in medically stable post-transplant populations and closely mirrors the fatigue profile in chronic fatigue syndrome. Understanding the shared mechanisms—inflammation, reduced activity tolerance, motivational impairment, and psychosocial factors—may illuminate common pathophysiology relevant to ME/CFS. The finding that fatigue was clinically underrecognized highlights a broader diagnostic blind spot that likely extends to ME/CFS-like presentations.
This study does not establish causality; it identifies correlations between fatigue and various markers (CRP, eGFR, sleep, mood) without determining which are causal versus consequential or confounded. The cross-sectional design cannot determine whether inflammation causes fatigue or fatigue leads to behavioral changes that increase inflammation. The study population is kidney transplant recipients and does not directly study ME/CFS patients, so findings may not directly apply to ME/CFS pathophysiology.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Chan, Winnie, Bosch, Jos A, Jones, David, Kaur, Okdeep, Inston, Nicholas, Moore, Sue, et al. (2013). Predictors and consequences of fatigue in prevalent kidney transplant recipients.. Transplantation. https://doi.org/10.1097/TP.0b013e3182a2e88b
BibTeX
@article{mecfsatlas-chan-2013-predictors-consequences,
author = {Chan, Winnie and Bosch, Jos A and Jones, David and Kaur, Okdeep and Inston, Nicholas and Moore, Sue and McClean, Andrew and McTernan, Philip G and Harper, Lorraine and Phillips, Anna C and Borrows, Richard},
title = {Predictors and consequences of fatigue in prevalent kidney transplant recipients.},
journal = {Transplantation},
year = {2013},
doi = {10.1097/TP.0b013e3182a2e88b},
note = {PubMed: 23982341},
url = {https://www.mecfsatlas.com/evidence/chan-2013-predictors-consequences},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/chan-2013-predictors-consequences
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