Risk of falls in people with chronic kidney disease and related factors

Carvalho, Thaís Carrera de; Dini, Ariane Polidoro

doi:10.1590/1518-8345.3911.3289

Acessibilidade / Reportar erro

Brasil

Revista Latino-Americana de Enfermagem

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Article • Rev. Latino-Am. Enfermagem 28 • 2020 • https://doi.org/10.1590/1518-8345.3911.3289 copy

Risk of falls in people with chronic kidney disease and related factors^* * Paper extracted from master´s thesis “Risk of falls in chronic renal patients on hemodialysis and its related factors”, presented to Universidade Estadual de Campinas, Faculdade de Enfermagem, Campinas, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

to identify the risk and prevalence of falls in the last year in chronic renal failure patients on hemodialysis; to associate the risk of falls with the fear of falling and socio-demographic-clinical variables.

Method:

association study. 131 individuals participated in the study. The Morse Falls Scale, the Fall Efficacy Scale and the Tilburg Frailty Indicator were used. The data were analyzed by linear regression, the level of significance adopted was 0.05.

Results:

97.7% were at risk for falls and 37.4% had at least one fall per year, with a mean of 2.02. Extreme concern about falling was presented by women, patients with less education, amputees, and frail individuals. Diabetes, as a comorbidity, and people with difficulty or need for assistance for ambulance showed a significant increase in the occurrence of falls.

Conclusion:

high risk and high prevalence of falls were found in hemodialysis patients, greater in those with diabetes or mobility limitations. Fear of falling was identified especially in women and in people with less education. These findings challenge the role of preventing falls, both in hemodialysis sessions and in the adoption of strategies for activities of daily living that involve patients and their families.

Descriptors:
Renal Insufficiency, Chronic; Renal Dialysis; Accidental Falls; Patient Safety; Nursing; Fall

Variable	Fall last year				p^† † p = Value;
	No		Yes
	n	%	n	%
Gender					0.0820^‡ ‡ p = Value obtained through the Chi-Square test;
Male	48	69.5	21	30.4
Female	34	54.8	28	45.1
Marital status					0.3273^‡ ‡ p = Value obtained through the Chi-Square test;
No partner	39	67.2	19	32.7
Has a partner	43	58.9	30	41.1
Systemic Arterial Hypertension					0.1283^‡ ‡ p = Value obtained through the Chi-Square test;
No	17	51.5	16	48.4
Yes	65	66.3	33	33.6
Diabetes Mellitus					0.0067^‡ ‡ p = Value obtained through the Chi-Square test;
No	58	71.6	23	28.4
Yes	24	48.0	26	52.0
Limb amputation					0.5356^§ § p = Value obtained through Fisher’s exact test
No	74	61.6	46	38.3
Yes	8	72.7	3	27.2
Difficulty walking					0.0314^‡ ‡ p = Value obtained through the Chi-Square test;
No	51	70.8	21	29.1
Yes	31	52.5	28	47.4
Walking aid device					0.0025^‡ ‡ p = Value obtained through the Chi-Square test;
No	76	67.8	36	32.1
Yes	6	31.5	13	68.4
Bone Mineral Disease					0.6483^‡ ‡ p = Value obtained through the Chi-Square test;
No	66	61.6	41	38.3
Yes	16	66.6	8	33.3
Tilburg					0.4834^‡ ‡ p = Value obtained through the Chi-Square test;
Not frail	47	65.2	25	34.7
Frail	35	59.3	24	40.6

	Morse Scale				p^† † p = Value ;
	No risk/Low risk		High risk
	n	%	n	%
Gender					0.6193^‡ ‡ p = Value per Chi-square test;
Male	43	62.3	26	37.6
Female	36	58.0	26	41.9
Marital status					0.4671^‡ ‡ p = Value per Chi-square test;
No partner	37	63.7	21	36.2
Has a partner	42	57.5	31	42.4
Systemic Arterial Hypertension					0.4343^‡ ‡ p = Value per Chi-square test;
No	18	54.5	15	45.4
Yes	61	62.2	37	37.7
Diabetes Mellitus					0.0237^‡
No	55	67.9	26	32.1
Yes	24	48.0	26	52.0
Limb amputation					1.0000^§ § p = Value by Fisher’s exact test
No	72	60.0	48	40.0
Yes	7	63.6	4	36.3
Difficulty walking					0.0001^‡ ‡ p = Value per Chi-square test;
No	54	75.0	18	25.0
Yes	25	42.3	34	57.6
Walking aid device					0.0002^‡ ‡ p = Value per Chi-square test;
No	75	66.9	37	33.0
Yes	4	21.0	15	78.9
Bone Mineral Disease					0.4809^‡ ‡ p = Value per Chi-square test;
No	63	58.8	44	41.1
Yes	16	66.6	8	33.3
Tilburg					0.3544^‡ ‡ p = Value per Chi-square test;
Not frail	46	63.8	26	36.1
Frail	33	55.9	26	44.0

Variable	FES^† † FES = Fall Efficacy Scale; (fear of falling)				p^‡ ‡ p = p-value;
	No/Little		Very/Extremely
	n	%	N	%
Gender					0.0040^§ § p = Value by Chi-square test;
Male	61	88.4	8	11.5
Female	42	67.7	20	32.2
Marital status					0.8648^§ § p = Value by Chi-square test;
No partner	46	79.3	12	20.6
Has a partner	57	78.0	16	21.9
Systemic Arterial Hypertension					0.6421^§ § p = Value by Chi-square test;
No	25	75.7	8	24.2
Yes	78	79.5	20	20.4
Diabetes Mellitus					0.1461^§ § p = Value by Chi-square test;
No	67	82.7	14	17.2
Yes	36	72.0	14	28.0
Limb amputation					0.7010^ǁ ǁ p = Value by Fisher’s exact test
No	95	79.1	25	20.8
Yes	8	72.7	3	27.2
Difficulty walking					<0.0001^§ § p = Value by Chi-square test;
No	67	93.0	5	6.9
Yes	36	61.0	23	38.9
Walking aid device					0.2395^ǁ ǁ p = Value by Fisher’s exact test
No	90	80.3	22	19.6
Yes	13	68.4	6	31.5
Bone Mineral Disease					0.1138^§ § p = Value by Chi-square test;
No	87	81.3	20	18.6
Yes	16	66.6	8	33.3
Tilburg					<0.0001^§ § p = Value by Chi-square test;
Not frail	66	91.6	6	8.3
Frail	37	62.7	22	37.2

Independent variables	PR^† † PR= Prevalence ratio;	CI^‡ ‡ IC = Confidence interval; (95%)		p^§ § Poisson regression;
Independent variables	PR^† † PR= Prevalence ratio;	Lower limit	Upper limit	p^§ § Poisson regression;
Fall in the last year
Gender (ref^ǁ ǁ ref = reference; = Male)	1.61	1.03	2.50	0.0358
DM^¶ ¶ DM = Diabetes mellitus (ref = No)	1.93	1.19	3.13	0.0075
Walking aid device (ref = No)	2.32	1.35	4.00	0.0023
High risk of fall
Difficulty walking (ref = No)	1.88	1.14	3.10	0.0131
Walking aid device (ref = No)	1.97	1.26	3.08	0.0032
“Very/Extremely concerned about falling”
Schooling	0.94	0.88	0.99	0.0399
Difficulty walking (ref = No)	4.74	1.85	12.16	0.0012
Tilburg (ref = Not frail)	2.47	1.03	5.94	0.0435

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Corresponding author: Ariane Polidoro Dini E-mail: adini@unicamp.br https://orcid.org/0000-0002-5830-9989

Brasil

Brasil

Risk of falls in people with chronic kidney disease and related factors* * Paper extracted from master´s thesis “Risk of falls in chronic renal patients on hemodialysis and its related factors”, presented to Universidade Estadual de Campinas, Faculdade de Enfermagem, Campinas, SP, Brazil.

Objective:

Method:

Results:

Conclusion:

Risk of falls in people with chronic kidney disease and related factors^* * Paper extracted from master´s thesis “Risk of falls in chronic renal patients on hemodialysis and its related factors”, presented to Universidade Estadual de Campinas, Faculdade de Enfermagem, Campinas, SP, Brazil.