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Among incident dialysis patients, 6.8% are unable to ambulate and 11.2% need assistance with daily activities.
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Heung M, Adamowski T, Segal JH, Malani PN. “A successful approach to fall prevention in an outpatient hemodialysis center. Clin J Am Soc Nephrol 5(10): 1775-9.
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A meta-analysis of randomized controlled trials found that supplemental vitamin D in a dose of 700-
1000 IU a day reduced the risk of falling among older
individuals by 19% and to a similar degree as active forms of vitamin D.
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Bischoff-Ferrari HA, Hughers BD, Staehelin HB, et al., “Fall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomised controlled trials,” Brit Med J (Oct 2009) 339:b3692.
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Hospitalizations and mortality increased two-fold for dialysis patients who fell once during a 3-year study period and more than tripled for those who had recurrent falls.
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Balogun R, Abdel-Rahman EM. “Successful maintenance hemodialysis in nonagenarians with end-stage renal disease and pre-existing comorbidities,” J Am Soc Geriatr (Jan 2009) 57(1):174-5.
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If 5% of patients fall in a three-month time period, and there are 304,799 End Stage Renal Disease patients nationwide, this results in an estimated 15,240 patient falls every three months.
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Health and Safety Survey to Improve Patient Safety in End Stage Renal Disease, page 18
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40% of patients who had fallen cited weakness or dizziness as the reason for their fall.
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Health and Safety Survey to Improve Patient Safety in End Stage Renal Disease, page 8
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There is a higher hip fracture rate in Caucasian U.S. hemodialysis patients than age, sex, and race matched nonuremic patients.
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A. M. Alem, D. J. Sherrard, D. L. Gillen et al., "Increased Risk of Hip Fracture Among Patients With End-Stage Renal Disease," Kidney International 58, no. 1 (2000): 396-399.
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In addition to fractures, head injuries, and lesions, falls often result in the patient becoming more cautious about future falls, leading to a reduction in physical activity. This reduction in physical activity leads to deconditioning of the patient, loss of lean tissue, and increased muscle weakness thereby increasing the likelihood of future falls.
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C. Desmet et al., "Falls in Hemodialysis Patients: Prospective Study of Incidence, Risk Factors, and Complications," American Journal of Kidney Disease 45, no. 1 (Jan 2005): 148-153. B. Brouwer, K. Musselman, E. Culham, "Physical Function and Health Status Among Seniors With and Without a Fear of Falling," Gerontology 50 no. 3 (May-Jun 2004): 135-141. E. M. Andresen et al., "Cross-Sectional and Longitudinal Risk Factors for Falls, Fear of Falling, and Falls Efficacy in a Cohort of Middle-Aged African Americans," Gerontologist 26, no. 2, (April 2006): 249-257.
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