Motor Coordination Disorders in Patients with Chronic Kidney Disease

Background: The number of senior chronic kidney disease (CKD) patients is steadily increasing worldwide. Falls are more frequent in this group than in the general population, and they are associated with a variety of complications ranging from minor (bruises) to severe (fracture, brain injury, or death). The significant burden of comorbidities, particularly cardiovascular disorders, impacts coordination. The aim of the study was to assess coordination disorders in CKD patients in the context of cardiovascular complications and vascular status. Methods: In this prospective study, 132 patients with CKD 2-5, including 40 (30%) hemodialysis patients, were enrolled. The short form physiological profile assessment (S-PPA) was used to assess coordination. Results: During a 2-year follow-up period, 49 individuals experienced 84 falls. The median S-PPA score (Z score) was 3.36. Based on this, we divided our cohort into two groups: a Z score of <3.36 and a Z score of ≥3.36. The groups with high scores (≥3.36) characterized by higher parameters of vessel stiffness, including AIx@75, augmentation pressure, and PWV, experienced considerably greater numbers of falls (41 vs. 8, p < 0.001), CV events (10 vs. 2, p < 0.05), and deaths (14 vs. 0, p < 0.001). Conclusions: Coordination impairments and the associated risk of falls in CKD patients are directly related to cardiovascular diseases and vascular conditions. Lower arterial compliance has been linked with the largest coordination disorder. Visual impairments, especially contrast sensitivity, are an independent risk factor for falls.