Original article

A cross-sectional study of falls in peritoneal dialysis patients

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  • 1. Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
    2. Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received date: 2021-07-22

  Online published: 2022-08-09

Abstract

Objective To explore the risk factors of falls in the patients receiving peritoneal dialysis and provide the basis for their safety managements. Methods A total of 147 patients receiving peritoneal dialysis who matched the requirements from January to December 2019 in the peritoneal dialysis clinic of our hospital were selected. In one year, the incidence of falls was retrospectively investigated through every three months’ evaluation. The Logistic multiple regression was used to analyze the independent risk factors of falls in these patients. Results A total of 51 falls occurred in 32 cases in one year, and the fall rate was 21.8%. The patients were divided into two groups, which were fall group and non-fall group. Comparing fall group with non-fall group, the risk factors for falls were as follows: diabetes (7.8% vs 21.9%, P=0.048), dialysis age [26.0 (11.0, 49.3) months vs 44.4(24.1, 76.8) months, P=0.002], endogenous creatinine clearance rate (CCR)[58.61(50.85,79.16) L/week vs 51.53 (45.39, 59.50) L/week, P=0.001], albumin [(36.6±4.1) g/L vs (34.9±4.3) g/L, P=0.047], phosphorus [1.6 (1.4, 1.9) mmol/L vs 1.7 (1.5, 2.2) mmol/L, P=0.05], 24-hour urine volume [700(60,1 100) mL/24h vs 75(0, 488) mL/24h, P=0.002], ultrafiltration volume of dialysate[600(300, 900) mL/24h vs 800(472,1 160) mL/24h, P=0.002], number of antihypertensive drugs (≤3: 80.9% vs 56.3%, ≥4: 19.1% vs 43.8%, P=0.004 2), amobility (no help 98.3% vs 87.5%, help or crutch 0 vs 12.5% and wheelchair 1.7% vs 0, P=0.021). The Logistic multiple regression analysis showed that diabetes [odds ratio(OR)=6.569, P=0.007], dialysis age(OR=1.022, P=0.011), blood phosphorus(OR=3.372, P=0.024), the use of antihypertensive drugs(OR=3.601, P=0.015), 24-hour urine volume(OR=1.001, P=0.039) were independent risk factors for falls. Conclusions The falls in the patient receiving peritoneal dialysis is the result of multiple factors, and it’s important to adopt necessary measures to prevent falls in these patients.

Cite this article

HUANG Xiaomin, ZHANG Qianying, YANG Li, CUI Yan, XU Tian, WANG Ziqiu, WANG Zhaohui, REN Hong, ZHANG Chunyan . A cross-sectional study of falls in peritoneal dialysis patients[J]. Journal of Internal Medicine Concepts & Practice, 2022 , 17(03) : 248 -252 . DOI: 10.16138/j.1673-6087.2022.03.014

References

[1] 刘昱秀, 商临萍. 不同管理模式在病人跌倒预防中的应用研究进展[J]. 护理研究, 2021, 35(6):1016-1020.
[2] 李芳, 刘素, 李长风, 等. 武汉市老年人意外伤害流行状况及其影响因素[J]. 医学与社会, 2020, 33(4):34-38.
[3] 刘悦, 米红. 居住环境对老年人跌倒风险的影响分析--基于中国城乡老年人生活状况抽样调查2015年数据[J]. 人口与发展, 2021, 27(3): 123-132.
[4] Wang HH, Wu JL, Lee YC, et al. Risk of serious falls between hemodialysis and peritoneal dialysis patients[J]. 2020, 10(1): 7799.
[5] Li PK, Chow KM, Van de Luijtgaarden MW, et al. Changes in the worldwide epidemiology of peritoneal dialysis[J]. Nat Rev Nephrol, 2017, 13(2): 90-103.
[6] 林建雄, 易春燕, 张小丹, 等. 长透析龄腹膜透析患者退出原因特征分析及管理策略[J]. 中国中西医结合肾病杂志, 2020, 21(11): 955-958.
[7] 白少虎, 常沁涛, 方敬爱, 等. 持续性不卧床腹膜透析患者透析龄与血钙、血磷、 iPTH的相关性分析及钙磷达标现状调查[J]. 中国中西医结合肾病杂志, 2020, 21(10): 889-891.
[8] 阮绍均, 赵可伟, 曾婷婷. 甲状旁腺激素、降钙素及血钙、血磷浓度联合检测对骨质疏松症的诊断价值[J]. 现代医药卫生, 2016, 32(18): 2866-2868.
[9] Ang GC, Low SL, How CH. et al. Approach to falls among the elderly in the community[J]. Singapore Med J, 2020, 61(3): 116-121.
[10] 高洪志, 罗健华, 陈万佳, 等. 合并2型糖尿病腹膜透析患者的转归及影响因素的单中心回顾性分析[J]. 中国血液净化, 2021, 20(3): 171-175.
[11] Umanath K, Lewis JB. Update on diabetic nephropathy: core curriculum 2018[J]. Am J Kidney Dis, 2018, 71(6): 884-895.
[12] Selvarajah D, Kar D, Khunti K, et al. Diabetic peripheral neuropathy: advances in diagnosis and strategies for screening and early intervention[J]. Lancet Diabetes Endocrinol, 2019, 7(12): 938-948.
[13] Hewston P, Deshpande N. Falls and balance impairments in older adults with type 2 diabetes: thinking beyond diabetic peripheral neuropathy[J]. Can J Diabetes, 2016, 40(1): 6-9.
[14] 谢志权. 老年2型糖尿病患者合并肌少症与肌功能减退的相关因素及跌倒风险分析[D]. 广州: 南方医科大学, 2019.
[15] 王倩倩, 张砚卓, 吴成爱. 中国中老年人群中跌倒的危险因素分析: 基于中国健康与养老追踪调查(CHARLS)数据[J]. 中国老年学杂志, 2019, 39(15): 3794-3799.
[16] 王晓君, 许阳, 周媛媛, 等. 中国社区老年人跌倒发生率的Meta分析[J]. 循证护理, 2020, 6(11): 1149-1154.
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