Table 1 Parameters summarizing the main studies dealing with falls in renal dysfunction patients. Author, number of patients and events, setting, study design, risk factors and main outcomes are reported
From: Renal disease and accidental falls: a review of published evidence
Author (year) | Sample (events) | Country & setting | Type of study (study period) | Fall risk factors main outcomes | Checklist (Reporting) |
|---|---|---|---|---|---|
Roberts (2003) | 47 patients | UK | Cross-sectional study | There were significantly more patients reporting falls and/or syncope in elderly patients who had post-dialysis orthostatic hypotension. | 15 |
(13) | 1 Hospital HD unit | (12 months) | |||
Cook (2005) | 135 patients | Canada | Cross-sectional study | There was no significant difference in the incidence of falls among “young-old” and “old-old” group in either gender. | 14 |
(37) | 2 Outpatient HD unit | (12 months) | |||
Desmet (2005) | 308 patients | Belgium | Prospective cohort study | Older age, diabetes, failed walking test, intake of an antidepressant and high number of oral prescribed drugs were identified as independent predictors of falling | 18 |
(56) | 7 In-center HD units | (8 weeks) | |||
Cook (2006) | 169 patients | Canada | Prospective cohort study | Male gender, a history falls, low mean pre-dialysis SBP, and higher comorbidity were important risk factors for falls | 22 |
(305 falls over a median of 468 days) | 1 Outpatient HD unit | (12 months) | |||
Angalakuditi (2007) | 635 cases & 1270 controls | USA | Retrospective case–control study | Increased likelihood of experiencing an in-hospital fall occurred with dementia, pneumonia, gastrointestinal disease and diabetes, as well as taking antidepressants and anticonvulsants. | 21 |
(Falls determine the cases: 635 cases) | 1 University medical center | (5 years & 6months) | |||
Roberts (2007) | 78 patients | UK | Prospective cohort study | Older patients fell more than younger patients. There was no relationship between incidence of falls and the routine blood pressures nor with hemoglobin concentration or number of medications. | 8 |
(14) | 1 Hospital HD unit | (6 months) | |||
Li (2008) | 162 patients | Canada | Prospective cohort study | Falls were associated with double risk of death. Risk of death increased with 1-year in dialysis or 1-year in age or with changes in hemoglobin, serum albumin and the calcium-phosphate product | 18 |
(305) | 1 Outpatient HD unit | (12 months) | |||
Boudville (2010) | 25 patients (9 with 25 OHD ≤50 nmol/l; 16 with 25 OHD > 50 nmol/l | Australia | Cross-sectional study | Suboptimal levels of 25 OHD may contribute to an increased risk of falls. Although, not significant, there were more falls in patients with suboptimal levels of 25 OHD. | 20 |
Not determine incidence of falls | 1 Outpatient HD unit | (No data) | |||
Abdel-Rahman (2011) | 76 patients | USA | Prospective cohort study | Female gender was a significant predictor of falls. Compared to ‘non-fallers’, ‘fallers’ had higher risk of death, nursing home admission, and increase in number and duration of hospital. | 18 |
(20) | 2 Outpatient HD unit | (12 months) | |||
Rossier (2012) | 84 patients | Switzerland | Prospective cohort study | POMA score along with age, a past history of falls, malnutrition and depression, were associated with severe falls. | 19 |
(31 severe falls) | 1 Hospital HD unit | (3 years) | |||
Galvão (2013) | 64 patients | Brasil | Cross-sectional study | No correlation between PTH serum levels and FES-I. Higher tendency to fall among the patients who presented low calcitriol serum levels. FES-I can be capable of discerning falling from no-falling patients in HD | 19 |
Not determine incidence of falls | 1 Outpatient HD unit | (No data) | |||
McAdams-DeMarco (2013) | 95 patients | USA | Prospective cohort study | Fragility is an independent fall risk factor adjusting for age, sex, race, comorbidity, disability, number of medications, marital status and education. No difference between younger and older adults was seen. | 14 |
(70) | 1 Outpatient HD unit | (15 months) | |||
Kutner (2014) | 762 patients | USA | Cross-sectional study | Frail patients were over twice as likely to report falls. Patients with depression (CES-D >18) and/or prescribed antidepressants were over 80 % more likely to be faller than were patients with no depression (CES-D < 18) and no prescribed antidepressants. | 17 |
(671) | 8 Outpatient HD unit | (12 months) | |||
Rothenbacher (2014) | 1385 patients | Germany | Prospective cohort study | 25 OHD serum level were associated with risk of first fall. Calcium levels modified the effect. No association existed between chronic kidney disease and risk of first fall. | 17 |
Not determine incidence of falls | Community | (12 months) |