Department of Rehabilitation, Niigata Rinko Hospital, Niigata 950-8725, Japan.
Department of Physical Therapy, Niigata University of Health and Welfare, Niigata 950-3198, Japan.
Nutrients. 2022 Aug 6;14(15):3225. doi: 10.3390/nu14153225.
Falls are a social problem that increase healthcare costs. Hemodialysis (HD) patients need to avoid falling because fractures increase their risk of death. Nutritional problems such as frailty, sarcopenia, undernutrition, protein-energy wasting (PEW), and cachexia may increase the risk of falls and fractures in patients with HD. This review aimed to summarize the impact of frailty, sarcopenia, undernutrition, PEW, and cachexia on falls in HD patients. The reported global incidence of falls in HD patients is 0.85-1.60 falls per patient per year. HD patients fall frequently, but few reports have investigated the relationship between nutrition-related problems and falls. Several studies reported that frailty and undernutrition increase the risk of falls in HD patients. Nutritional therapy may help to prevent falls in HD patients. HD patients' falls are caused by nutritional problems such as iatrogenic and non-iatrogenic factors. Falls increase a person's fear of falling, reducing physical activity, which then causes muscle weakness and further decreased physical activity; this cycle can cause multiple falls. Further research is necessary to clarify the relationships between falls and sarcopenia, cachexia, and PEW. Routine clinical assessments of nutrition-related problems are crucial to prevent falls in HD patients.
跌倒不仅是一个社会问题，还会增加医疗保健成本。血液透析（HD）患者需要避免跌倒，因为骨折会增加他们的死亡风险。衰弱、肌肉减少症、营养不良、蛋白质能量消耗（PEW）和恶病质等营养问题可能会增加 HD 患者跌倒和骨折的风险。本综述旨在总结衰弱、肌肉减少症、营养不良、PEW 和恶病质对 HD 患者跌倒的影响。报告的 HD 患者跌倒全球发生率为每位患者每年 0.85-1.60 次跌倒。HD 患者经常跌倒，但很少有报告调查营养相关问题与跌倒之间的关系。几项研究报告称，衰弱和营养不良会增加 HD 患者跌倒的风险。营养治疗可能有助于预防 HD 患者跌倒。HD 患者的跌倒由医源性和非医源性等营养问题引起。跌倒会增加人们对跌倒的恐惧，从而减少身体活动，进而导致肌肉无力和进一步减少身体活动；这种循环可能会导致多次跌倒。需要进一步研究来阐明跌倒与肌肉减少症、恶病质和 PEW 之间的关系。常规临床评估营养相关问题对于预防 HD 患者跌倒至关重要。
