Department of Rehabilitation, Niigata Rinko Hospital, Niigata, Japan.
Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata, 951-8510, Japan.
BMC Nephrol. 2022 Jul 6;23(1):237. doi: 10.1186/s12882-022-02877-6.
Patients with chronic kidney disease undergoing hemodialysis (HD) have a high incidence of falls. Impairment of balance function is a risk factor for falls in the general elderly, and no report examining the association between balance dysfunction and fall incidence in HD patients exists.
This prospective cohort study was conducted at a single center. The timed-up-and-go test (TUG) as a dynamic balance function was performed and length of the center of pressure (CoP) as a static balance function was measured before and after the HD session at baseline. Data of the number and detailed information of accidental falls for 1 year were collected. Multiple regression analyses were performed to assess the relationships between the number of falls and balance function.
Forty-three patients undergoing HD were enrolled in the study. During 1 year of observation, 24 (55.8%) patients experienced accidental falls. TUG time was longer, and CoP was shorter in the post-HD session than in the pre-HD session. Adjusted multiple regression analyses showed that the number of accidental falls was independently associated with TUG time in the pre-HD session (B 0.267, p < 0.001, R 0.413) and that in the post-HD session (B 0.257, p < 0.001, R 0.530), but not with CoP.
Dynamic balance was associated with fall incidence in maintenance HD patients. The evaluation and intervention of dynamic balance function might reduce the risk of falls in HD patients.
This study was carried out with the approval of the Niigata Rinko Hospital Ethics Committee (approval number 2005-92) (Registered on December 11, 2019) and registered in The University Hospital Medical Information Network (registration number 000040618 ).
接受血液透析（HD）治疗的慢性肾脏病患者跌倒发生率较高。平衡功能障碍是老年人跌倒的一个危险因素，而目前尚无研究检查 HD 患者平衡功能障碍与跌倒发生率之间的关系。
本前瞻性队列研究在单中心进行。在基线时，在 HD 治疗前后分别进行了计时起立行走测试（TUG）以评估动态平衡功能，测量了中心压力（CoP）长度以评估静态平衡功能。收集了 1 年内跌倒的次数和详细信息。进行多元回归分析以评估跌倒次数与平衡功能之间的关系。
共有 43 名接受 HD 治疗的患者纳入研究。在 1 年的观察期间，有 24 名（55.8%）患者发生了意外跌倒。与 HD 治疗前相比，HD 治疗后 TUG 时间延长，CoP 变短。校正后的多元回归分析显示，意外跌倒的次数与 HD 治疗前的 TUG 时间（B 0.267，p<0.001，R 0.413）和 HD 治疗后的 TUG 时间（B 0.257，p<0.001，R 0.530）独立相关，但与 CoP 无关。
动态平衡与维持性 HD 患者的跌倒发生率相关。对动态平衡功能的评估和干预可能会降低 HD 患者跌倒的风险。
本研究经新潟临津会医院伦理委员会批准（批准号 2005-92）（2019 年 12 月 11 日注册），并在大学医院医学信息网络（注册号 000040618）注册。
