Dialytic hemodynamics are associated with changes in gait speed

Area of Science:

• Nephrology
• Geriatrics
• Physical Therapy

Background:

• Functional impairment and reduced mobility are common in patients undergoing chronic hemodialysis (HD).
• Evaluating the impact of HD on physical performance and mobility is crucial for patient care.

Purpose of the Study:

• To investigate the association between hemodynamic changes during HD and alterations in gait speed.
• To assess the relationship between blood pressure fluctuations during HD and post-dialysis mobility.

Main Methods:

• Gait speed was measured pre- and post-HD in a cohort of chronic HD patients.
• Demographic, laboratory, and hemodynamic data were collected.
• Linear regression analysis examined associations between hemodynamic changes and gait speed.
• The Falls Efficacy Scale International (FES-I) was used to assess fall concerns.

Main Results:

• A mean decrease in gait speed of -0.06 m/s was observed post-HD.
• Greater decreases in systolic blood pressure (SBP) and diastolic blood pressure (DBP) during HD were significantly associated with decreased gait speed.
• The association between maximum BP drop and gait speed remained significant after covariate adjustment.
• No association was found between blood pressure changes and FES-I scores.

Conclusions:

• Patients on chronic HD experiencing significant blood pressure decreases during dialysis are at higher risk for reduced post-HD gait speed.
• Hemodynamic monitoring during HD may help identify patients susceptible to mobility decline.