Accidental falling in community-dwelling elderly with chronic kidney disease

Abstract

Purpose: The aim of the current study was to evaluate the association between a decreased estimated glomerular filtration rate (eGFR) and accidental falling in elderly patients who visited the day clinic of the department of geriatric medicine of the University of Medical Center Utrecht (UMCU).

Study design: A cross-sectional analysis with people aged ≥ 65 years of the Utrecht Cardiovascular Cohort was performed. Patients were stratified into different stages of kidney disease (< 45, 45-59, and ≥ 60 ml/min per 1.73 m²). Logistic regression models were used to evaluate the association between chronic kidney disease and falling.

Results: Our analysis included 1000 participants with a mean age 79.4 (± 6.6) years, of whom 38% had an eGFR of < 60 ml/min per 1.73 m² and 17% < 45 ml/min per 1.73 m². Univariate analysis showed a significant higher prevalence [odds ratio 1.75 (95% confidence interval 1.21-2.53; p ≤ 0.01)] of falling in the population with an eGFR < 45 ml/min per 1.73 m² compared to patients with an eGFR ≥ 60 ml/min per 1.73 m². After correcting for multiple potential confounders in the multivariate analysis, this association was no longer present.

Conclusions: In geriatric patients ≥ 65 years, patients with a decreased eGFR fall more often than patients with a preserved kidney function. This seems to be related with the risk profile of patients with CKD and not with a decreased eGFR itself, as after correcting for potential confounders no association remained. Nevertheless, accidental falling is a highly prevalent problem in the elderly CKD population. Therefore, nephrologists should actively ask about accidental falling, and thereby screen for high-risk patients.

Keywords: Accidental falls; Aged; Aged 80 and over; Chronic kidney failure; Chronic renal insufficiency.