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Physiological and pathological changes are main inducing factors of diminished kidney function, which includes trauma, infection, inflammation, immune response, blood circulatory disorder, etc.
1 A severe decrease in kidney function can lead to a buildup of toxins and impurities in the blood. This can cause people to feel tired, weak and can make it hard to concentrate. Another complication of kidney disease is anemia, which can cause weakness and fatigue.  You're having trouble sleeping.