Introduction Impaired activities of daily living (ADL) and falls are important issues in hemodialysis patients. So far, information is limited regarding self‐reported difficulty with ADL (ADL difficulty) in hemodialysis patients. Then, we compared the degree of ADL difficulty and the prevalence of fallers between hemodialysis patients and a nondialyzed control group. Also, the possible association between ADL difficulty and falls was examined. Methods This was a single center, cross‐sectional study including two groups of outpatients aged 50 years or older; 209 prevalent hemodialysis patients, and 139 nonrenal patients with diabetes mellitus, hypertension, and/or dyslipidemia (control group). ADL difficulty score was evaluated by a 48‐item questionnaire including six subscales of ADLs namely locomotion, eating, toileting, dressing, bathing, and grooming. Experience of falls in the previous year period was examined by a questionnaire. Findings The two groups did not differ significantly in age or sex. The hemodialysis group had a higher median (interquartile range) total score of ADL difficulty than the control group [10 (2–39) vs. 2 (0–10); p < 0.001] and a higher prevalence of fallers (73/209, 34.9% vs. 16/139, 11.5%; p < 0.001). In multivariable‐adjusted linear regression analyses, history of falls was independently associated with a higher score of ADL difficulty for total or each of the six subscales. Discussion The hemodialysis patients had a significantly higher ADL difficulty and a higher prevalence of fallers than the control group. Self‐reported ADL difficulty and falls were closely linked regardless of the patient group.

BackgroundXanthine oxidoreductase (XOR) inhibition reduces reactive oxygen species (ROS) production and enhances adenosine triphosphate (ATP) synthesis. We investigated the protective effects of XOR inhibitor treatment on sarcopenia, frequently observed in patients undergoing hemodialysis (HD), in which increased ROS and ATP shortage are known to be involved.MethodsThis retrospective cross-sectional study included 296 HD patient (203 males, 93 females). Muscle mass, physical performance, and muscle strength were assessed using dual-energy X-ray absorptiometry, five-time chair stand testing, and handgrip strength, respectively. The Asian Working Group for Sarcopenia 2019 criteria were used to define low muscle mass, low physical performance, and low muscle strength, as well as sarcopenia and severe sarcopenia.ResultsSarcopenia and severe sarcopenia prevalence rates were 42.2 and 20.9%, respectively. XOR inhibitor users (n = 119) showed a significantly (p &lt; 0.05) lower prevalence of sarcopenia and severe sarcopenia, as well as reduced muscle mass, physical performance, and muscle strength than non-users (n = 177). Multivariate logistic regression analyses also revealed XOR inhibitor use to be significantly associated with low muscle mass [odds ratio (OR), 0.384; 95% confidence interval (CI), 0.183–0.806; p = 0.011] and low physical performance (OR, 0.286; 95% CI, 0.142–0.578; p &lt; 0.001), while significance with low muscle strength was borderline. Furthermore, XOR inhibitor use was significantly associated with sarcopenia (OR, 0.462; 95% CI, 0.226–0.947; p = 0.035) and severe sarcopenia (OR, 0.236; 95% CI, 0.091–0.614; p = 0.003).ConclusionsXOR inhibitor use was significantly associated with reduced risk of sarcopenia/severe sarcopenia in HD patients, suggesting that XOR inhibitor treatment has protective effects on sarcopenia in HD patients.

Background Glycated albumin, in contrast to glycated haemoglobin, precisely reflects glycaemic control and predicts all-cause mortality in haemodialysis patients with diabetes mellitus. However, whether those associations exist in diabetes mellitus patients receiving peritoneal dialysis remains unclear. Methods This was a retrospective cross-sectional and longitudinal observational study. We measured glycated albumin, glycated haemoglobin and casual plasma glucose for two months in diabetes mellitus-peritoneal dialysis ( n = 44) and diabetes mellitus-haemodialysis ( n = 88) patients (age-, gender-matched). The diabetes mellitus-peritoneal dialysis patients were followed for three years to monitor occurrence of all-cause mortality. Results Glycated albumin and glycated albumin/casual plasma glucose ratios, but not casual plasma glucose, glycated haemoglobin, or glycated haemoglobin/casual plasma glucose, were significantly lower in the diabetes mellitus-peritoneal dialysis as compared with the diabetes mellitus-haemodialysis patients. The regression lines between casual plasma glucose and glycated albumin showed a significant parallel shift downwards in diabetes mellitus-peritoneal dialysis as compared with diabetes mellitus-haemodialysis patients, while the slope did not differ significantly between the groups, resulting in underestimation of glycaemic control by 4.5%. Kapan-Meier analysis of the diabetes mellitus-peritoneal dialysis patients revealed that higher glycated albumin (median >18.0%), but not glycated haemoglobin (median >6.6%), indicated significantly elevated risk for all-cause mortality, which occurred in 15 patients (34.1%), as compared with those with a lower glycated albumin concentration. Higher glycated albumin concentration was also significantly and independently associated with all-cause mortality in multivariate Cox proportional hazards analysis. Conclusions Glycated albumin, in contrast to glycated haemoglobin, more precisely reflects glycaemic control in diabetes mellitus-peritoneal dialysis patients, based on its significant association with all-cause mortality. Furthermore, adjustment of the true glycated albumin concentration by adding 4.5% might provide a more precise measurement for determining glycaemic control in such patients.