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January 15, 2011

New study shows dialysis patients who fall have added mortality risk

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Hemodialysis (HD) patients who fall once or more have a higher risk of hospitalizations and mortality than their sure-footed counterparts, researchers at the University of Virginia Health System have reported.

During a presentation at the 29th Annual Dialysis Conference last month, UVA nephrologists Emaad Abdel-Rahman, M.D., and Rasheed A. Balogun, M.D., discussed the preliminary results of a three-year study of 76 HD patients. Findings showed that the risk of both hospitalizations and mortality increased two-fold for dialysis patients who fell once during the study period and more than tripled for those who had recurrent falls.

“Falls are highly prevalent among dialysis patients because many develop bone and muscle weakness and experience circulatory changes,” explained Balogun, who served as study leader and is associate professor of clinical internal medicine. Because falling and mortality are linked, Balogun recommended that dialysis centers routinely screen patients for falls and emphasize efforts to minimize fall recurrence.

Patients in the study group had a mean age of 62.4 years and had been on HD for a mean of 4.4 years. The cohort was 38.1 percent female and 35.5 percent white. During the first year, 14 patients fell once and six fell repeatedly.

Twenty-two patients died during the study’s two-year follow-up period. Of those, five had fallen once and three had suffered recurrent falls.

Before confirming the link between falling and increased risk of dying, the researchers adjusted their data for age, albumin, blood pressure and phosphorus – factors that are significantly associated with mortality among HD patients.

In addition to Balogun and Abdel-Rahman, who is section head of geriatric dialysis and an associate professor in the Department of Medicine, Division of Nephrology, the UVA research team included Guofen Yan, PhD, assistant professor in the Department of Public Health Sciences, Division of Biostatistics and Epidemiology.

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