Falls among hemodialysis patients: potential opportunities for prevention?

Falls among patients undergoing maintenance hemodialysis (HD) have significant consequences for quality of life and functional independence, morbidity, healthcare utilization and even mortality, but studies on the etiology of falls within large HD cohorts are limited.

Falls during the past 12 months were ascertained for a prevalent multi-center HD cohort (n = 762) aged 20-92 years, and associations with demographic and treatment characteristics, comorbidities, cognitive function, prescribed medications, balance tests, frailty and depressive symptoms were assessed.

Falls were sustained by 28.4% of participants. In multivariable-adjusted analyses, participants classified as frail were over two times more likely to report falls [odds ratio (OR): 2.39, 95% confidence interval (CI): 1.22-4.71, P = 0.01], and participants with a CES-D score 18+ and/or prescribed antidepressants were over 80% more likely to be fallers (OR: 1.83, 95% CI: 1.23-2.74, P = 0.003) than were participants with a CES-D score <18 and no prescribed antidepressants.

Frailty and depressed mood, factors that are potentially modifiable, are prominently associated with falls.