Risk Factors for Falls in Patients on Hemodialysis: A 12-Month Prospective Study

IF 1.4 4区医学 Q3 UROLOGY & NEPHROLOGY

Hemodialysis International Pub Date : 2026-07-09 Epub Date: 2026-03-10 DOI:10.1111/hdi.70068

Luciana Angélica da Silva de Jesus, Bruno Valle Pinheiro, Ana Clara Cattete Bainha, Rodrigo Schinniger Assun Garcia, Letícia Maria do Carmo Corrêa, Helena Faria Mucci, Erich Vidal Carvalho, Pelagia Koufaki, Leda Marília Fonseca Lucinda, Cristino Carneiro Oliveira, Maycon Moura Reboredo

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Abstract

Background

Patients on hemodialysis have comorbidities and malnutrition and are subject to polypharmacy, which contributes to disability and sarcopenia. These conditions increase the risk of falls and are associated with fractures, morbidities, substantial costs, nursing home admissions, hospitalization, and mortality.

Objective

This prospective study evaluated the association of physical function, postural balance, frailty, fear of falling, and quality of life with the occurrence and number of falls within a 12-month interval in patients on hemodialysis.

Methods

Patients were assessed for physical function (gait speed over 15 ft., timed up and go [TUG] test, 5-repetition sit-to-stand [5-STS] test, and handgrip strength), postural balance (Mini-Balance Evaluation Systems Test [Mini-BESTest]), frailty, fear of falling (Falls Efficacy Scale-International [FES-I]), and quality of life (36-Item Short Form Health Survey [SF-36]). Interviews were conducted for 12 months to monitor falls.

Results

One hundred twelve patients were included and the incidence rate was 1.62 falls/person-years. The occurrence of falls was associated with the TUG (OR: 1.24; 95% CI: 1.01–1.53) and 5-STS (OR: 1.11, 95% CI: 1.02–1.21) performance and frailty (OR: 7.22, 95% CI: 1.71–30.50). The number of falls was associated with the gait speed (OR: 0.22; 95% CI: 0.06–0.77), TUG test results (OR: 1.37; 95% CI: 1.16–1.62), handgrip strength (OR: 0.95; 95% CI: 0.91–0.99), Mini-BESTest (OR: 0.87; 95% CI: 0.78–0.96), frailty (OR: 4.43; 95% CI: 1.87–10.51), FES-I score (OR: 1.11; 95% CI: 1.06–1.17), and SF-36 scores in the physical functioning (OR: 0.98; 95% CI: 0.96–0.99), physical role (OR: 0.99; 95% CI: 0.98–0.99), and physical component summary (OR: 0.96; 95% CI: 0.92–0.99) domains.

Conclusions

Patients undergoing hemodialysis have a higher incidence of falls. Falls are associated with physical function, postural balance, frailty, and quality of life.

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血液透析患者跌倒的危险因素：一项为期12个月的前瞻性研究

背景：血液透析患者有合并症和营养不良，并受到多种药物的影响，这有助于残疾和肌肉减少。这些情况增加了跌倒的风险，并与骨折、发病率、大量费用、疗养院入院、住院和死亡率有关。目的：本前瞻性研究评估血液透析患者的身体功能、体位平衡、虚弱、害怕跌倒和生活质量与12个月内跌倒的发生和次数的关系。方法：评估患者的身体功能（步态速度超过15英尺）。(5)、姿势平衡（迷你平衡评估系统测试[Mini-BESTest]）、虚弱、害怕跌倒（国际跌倒效能量表[FES-I]）和生活质量（36项简短健康调查[SF-36]）。访谈进行了12个月，以监测跌倒情况。结果：纳入112例患者，发病率为1.62次/人年。跌倒的发生与TUG （OR: 1.24; 95% CI: 1.01-1.53）和5-STS （OR: 1.11, 95% CI: 1.02-1.21）的表现和虚弱（OR: 7.22, 95% CI: 1.71-30.50）有关。跌倒次数与步速（OR: 0.22; 95% CI: 0.06-0.77）、TUG测试结果（OR: 1.37; 95% CI: 1.16-1.62）、握力（OR: 0.95; 95% CI: 0.91-0.99）、mini - best （OR: 0.87; 95% CI: 0.78-0.96）、虚弱（OR: 4.43; 95% CI: 1.87-10.51）、FES-I评分（OR: 1.11; 95% CI: 1.06-1.17）和SF-36在身体功能（OR: 0.98; 95% CI: 0.96-0.99）、身体角色（OR: 0.99; 95% CI: 0.98-0.99）和身体成分总结（OR: 0.96; 95% CI: 0.92-0.99）领域的得分相关。结论：血液透析患者有较高的跌倒发生率。跌倒与身体功能、姿势平衡、虚弱和生活质量有关。

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来源期刊

Hemodialysis International UROLOGY & NEPHROLOGY-

CiteScore

2.50

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Hemodialysis International was originally an annual publication containing the Proceedings of the International Symposium on Hemodialysis held in conjunction with the Annual Dialysis Conference. Since 2003, Hemodialysis International is published quarterly and contains original papers on clinical and experimental topics related to dialysis in addition to the Annual Dialysis Conference supplement. This journal is a must-have for nephrologists, nurses, and technicians worldwide. Quarterly issues of Hemodialysis International are included with your membership to the International Society for Hemodialysis. The journal contains original articles, review articles, and commentary to keep readers completely updated in the field of hemodialysis. Edited by international and multidisciplinary experts, Hemodialysis International disseminates critical information in the field.