Long-Term Morbidity and Mortality Related to Falls in Hemodialysis Patients: Role of Age and Gender – A Pilot Study

Abdel‐Rahman, Emaad M.; Gao, Yan; Turgut, Faruk; Balogun, Rasheed A.

doi:10.1159/000322275

Cited by 41 publications

(47 citation statements)

References 62 publications

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“…This percentage increases to 35% after the age of 75 years 4 . Falls and their complications are the fifth leading cause of death in the developed world 5 with substantial cost 6 . More specifically in the United States the total cost of the fall-related fractures exceeds $US10 billions 7 .…”

Section: Introductionmentioning

confidence: 99%

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Risk of falls in chronic kidney disease

Papakonstantinopoulou¹,

Sofianos

2017

JFSF

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Section: Introductionmentioning

confidence: 99%

“…Moreover, they have a three to four times greater risk for hip fractures compared to the general population 8,9 . The morbidity and mortality are higher in the hemodialysis population 6 and in peritoneal dialysis patients as well 10 .…”

Section: Introductionmentioning

confidence: 99%

Risk of falls in chronic kidney disease

Papakonstantinopoulou¹,

Sofianos

2017

JFSF

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“…Even falls that do not result in injury are associated with a loss of confidence and predict a reduction in activity level and reduced ability to care for oneself (2,4,5). Patients maintained on chronic dialysis are, by virtue of the high rates of multimorbidity, polypharmacy, muscular dysfunction, and cognitive deficits, at higher risk of falls, with data suggesting falls rates of 1.2-1.6 per person-year among patients treated with hemodialysis (HD) (6)(7)(8)(9). As seen in nonrenal geriatric studies, patients stable on HD who experience one or more falls are at approximately 2-fold higher risk of death (after adjustment for known mortality risk factors) than patients who do not fall (10).…”

Section: Introductionmentioning

confidence: 99%

Accidental Falls and Risk of Mortality among Older Adults on Chronic Peritoneal Dialysis

Farragher

Chiu

Ulutaş

et al. 2014

Clinical Journal of the American Society of Nephrology

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Background and objectives More than 40% of elderly hemodialysis patients experience one or more accidental falls within a 1-year period. Such falls are associated with higher mortality. The objectives of this study were to assess whether falls are also common in elderly patients established on peritoneal dialysis and evaluate if patients with falls have a higher risk of mortality than patients who do not experience a fall.Design, setting, participants, & measurements Using a prospective cohort study design, patients ages$65 years on chronic peritoneal dialysis from April 2002 to April 2003 at the University Health Network were recruited. Patients were followed biweekly, and falls occurring within the first 15 months were recorded. Outcome data were collected until death, study end (July 31, 2012), transplantation, or transfer to another dialysis center.Results Seventy-four of seventy-six potential patients were recruited, assessed at baseline, and followed biweekly for falls; 40 of 74 (54%) peritoneal dialysis patients experienced 89 falls (adjusted mean fall rate, 1.7 falls per patient-year; 95% confidence interval, 1.0 to 2.7). Patients with falls were more likely to have had previous falls, be more recently initiated onto dialysis, be men, be older, and have higher comorbidity. Twenty-eight patients died during the follow-up period. After adjustment for known risk factors, each successive fall was associated with a 1.62-fold higher mortality (hazard ratio, 1.62; 95% confidence interval, 1.29 to 2.02; P,0.001).Conclusions Accidental falls are common in the peritoneal dialysis population and often go unrecognized. Falls were associated with higher mortality risk. Because fall interventions are effective in other populations, screening peritoneal dialysis patients for falls may be a simple measure of clinical importance.

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“…HD comorbidities include cardiovascular disease, neurological disorders, cerebrovascular disease, diabetes mellitus and peripheral vascular disease (5). Falls could also increase the likelihood of morbidity and mortality (6,7) and poorer quality of life in HD patients (8). In previous studies among elderly patients, most of the fall-related injuries were minor; however, nearly one third of all falls resulted in serious injury (9) and 10-15% of falls led to fracture (10).…”

Section: Introductionmentioning

confidence: 99%

Fall Incidence and Risk Factors in Hemodialysis Patients

Yekta¹,

Fatollahierad²,

Hassabi³

et al. 2016

Turk Neph Dial Transpl

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OBJECTIVE:The aims of this study were to assess the incidence, risk factors and complications of falls in the hemodialysis (HD) population. MATERIAL and METHODS:Using a prospective study design, chronic HD patients aged ≥50 years were recruited. The baseline characteristics and laboratory markers of all study participants were recorded. Participants were followed prospectively for 12 weeks. Patients were questioned thrice weekly about fall incidents. RESULTS:A total of 34 patients (mean age 69.1 year) participated in this study. A total of 16 falls occurred in nine (26%) patients over 12 weeks of follow-up with an incidence rate of 1.30 falls/patientyear. By applying univariate logistic regression analysis, previous fall history (odds ratio 10.5, P-value= 0.008), high parathyroid hormone level (odds ratio 1.032, P-value= 0.016) and impaired balance (odds ratio 9.00, P-value= 0.01) were identified as significant risk factors for falls. CONCLUSION:We concluded that high parathyroid hormone levels might be an important predictor of falling in HD patients in addition to impaired balance and previous fall history. As such, parathyroid hormone is a crucial factor to target for future intervention strategies aimed at reducing the fall incidence in the HD population. GEREÇ ve yÖNTEMLER:İleriye yönelik olarak ≥50 yaşta kronik hemodiyaliz hastaları çalışmaya alındı. Temel özellikler ve laboratuvar sonuçları tüm katılımcılarda kaydedildi. Katılımcılar 12 hafta boyunca takip edildi ve düşmeyle ilgili olarak haftada üç kez sorgulandı.BULGULAR: Çalışmaya toplam 34 hasta (ortalama yaş: 69,1) katıldı. Genel olarak,12 haftalık takip boyunca 1,30 düşüş/hasta-yıl oranıyla 9 hastada (26%) 16 düşüş gerçekleşti.Tek değişkenli regresyon analizi kullanılarak, önceki düşme (risk oranı 10,5, P değeri= 0,008), yüksek paratiroid hormonu düzeyi (risk oranı 1,032, P değeri= 0,016) ve denge sorunu (risk oranı 9,00, P değeri= 0,01) düşme için en temel riskler olarak saptandı. SONUÇ:Hemodiyaliz hastalarında yüksek paratiroid hormonu düzeyleri denge sorunu ve önceki düşmenin yanında düşmenin öngörülmesinde en önemli faktörlerden biri olabilir. Bu nedenle paratiroid hormonu, hemodiyaliz hastalarında düşmelerin azalması yönünde gelecekteki müdahale stratejilerinde hedef alınabilecek temel bir faktördür.

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Long-Term Morbidity and Mortality Related to Falls in Hemodialysis Patients: Role of Age and Gender – A Pilot Study

Cited by 41 publications

References 62 publications

Risk of falls in chronic kidney disease

Risk of falls in chronic kidney disease

Accidental Falls and Risk of Mortality among Older Adults on Chronic Peritoneal Dialysis

Fall Incidence and Risk Factors in Hemodialysis Patients

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