Jerzak Patryk, Kusztal Mariusz, Dziubek Wioletta, Rogowski Łukasz, Ostrowska Bożena, Gołębiowski Maciej, Bronikowska Paulina, Chumadevska Maria, Stojanowski Jakub, Gołębiowski Tomasz
Clinical Department of Nephrology, Transplantation Medicine and Internal Diseases, Wroclaw Medical University, 50-367 Wroclaw, Poland.
Faculty of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland.
J Clin Med. 2025 Apr 18;14(8):2804. doi: 10.3390/jcm14082804.
: The number of senior chronic kidney disease (CKD) patients is steadily increasing worldwide. Falls are more frequent in this group than in the general population, and they are associated with a variety of complications ranging from minor (bruises) to severe (fracture, brain injury, or death). The significant burden of comorbidities, particularly cardiovascular disorders, impacts coordination. The aim of the study was to assess coordination disorders in CKD patients in the context of cardiovascular complications and vascular status. : In this prospective study, 132 patients with CKD 2-5, including 40 (30%) hemodialysis patients, were enrolled. The short form physiological profile assessment (S-PPA) was used to assess coordination. : During a 2-year follow-up period, 49 individuals experienced 84 falls. The median S-PPA score (Z score) was 3.36. Based on this, we divided our cohort into two groups: a Z score of <3.36 and a Z score of ≥3.36. The groups with high scores (≥3.36) characterized by higher parameters of vessel stiffness, including AIx@75, augmentation pressure, and PWV, experienced considerably greater numbers of falls (41 vs. 8, < 0.001), CV events (10 vs. 2, < 0.05), and deaths (14 vs. 0, < 0.001). : Coordination impairments and the associated risk of falls in CKD patients are directly related to cardiovascular diseases and vascular conditions. Lower arterial compliance has been linked with the largest coordination disorder. Visual impairments, especially contrast sensitivity, are an independent risk factor for falls.
全球范围内，老年慢性肾脏病（CKD）患者数量正在稳步增加。相较于普通人群，该群体中跌倒更为频繁，且与从轻微（瘀伤）到严重（骨折、脑损伤或死亡）的各种并发症相关。合并症负担沉重，尤其是心血管疾病，会影响协调性。本研究的目的是在心血管并发症和血管状态的背景下评估CKD患者的协调性障碍。
在这项前瞻性研究中，纳入了132例CKD 2 - 5期患者，其中40例（30%）为血液透析患者。采用简化生理功能评估量表（S - PPA）评估协调性。
在为期2年的随访期内，49人发生了84次跌倒。S - PPA评分中位数（Z评分）为3.36。据此，我们将队列分为两组：Z评分<3.36组和Z评分≥3.36组。高分（≥3.36）组的血管僵硬度参数较高，包括AIx@75、增强压和脉搏波速度（PWV），跌倒次数（4个月）显著更多（41次对8次，<0.001）、心血管事件（10次对2次，<0.05）和死亡（14次对0次，<0.001）。
CKD患者的协调性损害及相关跌倒风险与心血管疾病和血管状况直接相关。较低的动脉顺应性与最大的协调性障碍有关。视力损害，尤其是对比敏感度，是跌倒的独立危险因素。
