Factors associated with falls in hemodialysis patients: a case-control study

Abstract

Objective: to identify possible associations between a higher probability of falls among hemodialysis patients and laboratory values, comorbidities, pharmacological treatment, hemodynamic changes, dialysis results and stabilometric alterations. Method: this was a retrospective case-control study with hemodialysis patients. Patients in a hemodialysis unit who had suffered one or more falls were included in the case group. Patients from the same unit who had not suffered falls were the controls. Data were gathered from the patients’ clinical history and also from the results of a balance test conducted six months before the study. Results: thirty-one patients were included (10 cases and 21 controls). Intradialytic body weight change was significantly greater among cases (p <0.05). Patients in the case group also presented greater lateral instability after dialysis (p <0.05). Other factors such as high blood pressure, antihypertensives, beta-blockers, and lower heart rates were also associated with falls. Conclusion: a greater intradialytic weight change was associated with an increase in risk of falls. Nursing staff can control these factors to prevent the incidence of falls in dialysis patients.

Influence of medications on fall risk assessment in maintenance hemodialysis patients: A cross-sectional study

“…The combination of other antihypertensive and diuretic medications may result in electrolyte imbalances and orthostatic hypotension, both of which can increase fall risk. [ 6 24 25 26 ] A recent research assessing factors involved in fall risk of patients undergoing maintenance HD could not study the effects of medications on fall risk. Moreover, the researchers commented that the relationship between medication and fall risk in the dialysis population is inconsistent in the literature.…”

“…Mineral bone disorder, electrolyte imbalance, anemia-related symptoms, metabolic acidosis, polypharmacy, malnutrition, muscle atrophies and fatigue, intradialytic hypotension, dialysis-related arrhythmias, and peripherical and autonomic neuropathies are just a few of the factors that contribute to an increased risk of falls in ESRD patients. [ 4 5 6 7 8 9 ]…”

A Randomized Controlled Trial of Whole-Body Vibration on Gait Ability and Balance among Older Hemodialysis Patients

“…[3][4][5] Furthermore, gait abnormality contributes to a higher risk of falls. [6][7][8] Indeed, the incident rate of falls among hemodialysis patients is 1.18-1.60 per patient-year, [9][10][11] which is much higher than that in the general older population ($65 years), at approximately 0.67 per person-year. 12 Serious fall injuries, such as fractures and brain injury, increase after dialysis initiation, 13 which can lead to loss of independence.…”