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Risk factors for high fall risk in elderly patients with chronic kidney disease

  • Nephrology - Original Paper
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Abstract

Purpose

Patients with chronic kidney disease (CKD) usually represent an aging population, and both older age and CKD are associated with a higher risk of falling. Studies on risk factors among subjects with CKD are lacking.

Methods

Records of outpatients from one geriatric clinic in Turkey were retrospectively reviewed. A result of ≥ 13.5 s on the timed up and go (TUG) test was accepted as a high risk of falls. Independent predictors of an increased risk of falls among subjects with CKD (estimated glomerular filtration rate of < 60 mL/min/1.73 m2) were identified using logistic regression models.

Results

Patients with CKD (n = 205), represented the 20.2% of the entire cohort and was identified as an independent predictor of increased fall risk (OR 2.59). Within the CKD cohort, serum folic acid levels and frailty were independent predictors of an increased risk of falls. The CKD/fall risk group was older, had a lower median years of education, lower vitamin D levels, and lower serum folic acid levels than the CKD/non-fall risk group. In addition to higher serum creatinine and potassium levels, the only significant difference between patients with CKD/fall risk and a matched non-CKD/fall risk was a lower median folic acid level in the former group.

Conclusions

Frailty and low folic acid levels are independently associated with an increased risk of falls among elderly outpatients with CKD. Prevention of frailty may reduce the risk of falls in these subjects. Possible benefit of folic acid supplementation requires further studies.

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Authors and Affiliations

  1. Division of Nephrology, Muş State Hospital, Muş, Turkey

    Cihan Heybeli

  2. Department of Nephrology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey

    Rumeyza Kazancioglu

  3. The Cambridge Centre for Sport and Exercise Science, Anglia Ruskin University, Cambridge, UK

    Lee Smith

  4. Department of Internal Medicine, University of Palermo, Geriatrics Section, Palermo, Italy

    Nicola Veronese

  5. Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Adnan Menderes Bulvarı (Vatan Street), 34093, Fatih, İstanbul, Turkey

    Pinar Soysal

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  1. Cihan Heybeli
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  2. Rumeyza Kazancioglu
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  3. Lee Smith
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  4. Nicola Veronese
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  5. Pinar Soysal
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Contributions

Conceptualization and design: CH, RK, PS. Acquisition of data: CH, PS. Analysis and interpretation: CH, LS, PS, RK, NV. Drafting the manuscript: CH. Critical review and editing: RK, LS, NV, PS. Supervision: PS.

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Correspondence to Pinar Soysal.

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Heybeli, C., Kazancioglu, R., Smith, L. et al. Risk factors for high fall risk in elderly patients with chronic kidney disease. Int Urol Nephrol 54, 349–356 (2022). https://doi.org/10.1007/s11255-021-02884-w

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