Risk of fall in patients with chronic kidney disease: results from the China health and retirement longitudinal study (CHARLS)

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Abstract

Background

Chronic kidney disease (CKD), often coexisting with various systemic disorders, may increase the risk of falls. Our study aimed to assess the prevalence and risk of falls among patients with CKD in China.

Methods

We included patients with/without CKD from China Health and Retirement Longitudinal Study (CHARLS). Our primary outcome was the occurrence of fall accidents within the past 2 years. To enhance the robustness of our findings, we employed a multivariable logistic regression model, conducted propensity score analysis, and applied an inverse probability-weighting model.

Results

A total of 12,658 participants were included, the prevalence of fall accident rates were 17.1% (2,028/11,837) among participants without CKD and 24.7% (203/821) among those with CKD. In the inverse probability-weighting model, participants with CKD exhibited higher fall accident rates (OR = 1.28, 95% CI: 1.08–1.53, p = 0.005 ). Sensitivity and subgroup analysis showed the results still stable.

Conclusions

The population in China afflicted with CKD has a significantly heightened risk of experiencing falls, underscoring the crucial importance of intensifying efforts in assessing and preventing fall risks.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-024-17982-4.

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Most cited references 30

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Global Prevalence of Chronic Kidney Disease – A Systematic Review and Meta-Analysis

Nathan Hill, Samuel T Fatoba, Jason L. Oke … (2016)

Chronic kidney disease (CKD) is a global health burden with a high economic cost to health systems and is an independent risk factor for cardiovascular disease (CVD). All stages of CKD are associated with increased risks of cardiovascular morbidity, premature mortality, and/or decreased quality of life. CKD is usually asymptomatic until later stages and accurate prevalence data are lacking. Thus we sought to determine the prevalence of CKD globally, by stage, geographical location, gender and age. A systematic review and meta-analysis of observational studies estimating CKD prevalence in general populations was conducted through literature searches in 8 databases. We assessed pooled data using a random effects model. Of 5,842 potential articles, 100 studies of diverse quality were included, comprising 6,908,440 patients. Global mean(95%CI) CKD prevalence of 5 stages 13·4%(11·7–15·1%), and stages 3–5 was 10·6%(9·2–12·2%). Weighting by study quality did not affect prevalence estimates. CKD prevalence by stage was Stage-1 (eGFR>90+ACR>30): 3·5% (2·8–4·2%); Stage-2 (eGFR 60–89+ACR>30): 3·9% (2·7–5·3%); Stage-3 (eGFR 30–59): 7·6% (6·4–8·9%); Stage-4 = (eGFR 29–15): 0·4% (0·3–0·5%); and Stage-5 (eGFR<15): 0·1% (0·1–0·1%). CKD has a high global prevalence with a consistent estimated global CKD prevalence of between 11 to 13% with the majority stage 3. Future research should evaluate intervention strategies deliverable at scale to delay the progression of CKD and improve CVD outcomes.

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Falls in older people: epidemiology, risk factors and strategies for prevention.

Laurence Z. Rubenstein (2006)

Falls are a common and often devastating problem among older people, causing a tremendous amount of morbidity, mortality and use of health care services including premature nursing home admissions. Most of these falls are associated with one or more identifiable risk factors (e.g. weakness, unsteady gait, confusion and certain medications), and research has shown that attention to these risk factors can significantly reduce rates of falling. Considerable evidence now documents that the most effective (and cost-effective) fall reduction programmes have involved systematic fall risk assessment and targeted interventions, exercise programmes and environmental-inspection and hazard-reduction programmes. These findings have been substantiated by careful meta-analysis of large numbers of controlled clinical trials and by consensus panels of experts who have developed evidence-based practice guidelines for fall prevention and management. Medical assessment of fall risks and provision of appropriate interventions are challenging because of the complex nature of falls. Optimal approaches involve interdisciplinary collaboration in assessment and interventions, particularly exercise, attention to co-existing medical conditions and environmental inspection and hazard abatement.

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Falls and Fall Injuries Among Adults Aged ≥65 Years - United States, 2014.

Gwen Bergen, Mark R Stevens, Elizabeth Burns (2016)

Falls are the leading cause of fatal and nonfatal injuries among adults aged ≥65 years (older adults). During 2014, approximately 27,000 older adults died because of falls; 2.8 million were treated in emergency departments for fall-related injuries, and approximately 800,000 of these patients were subsequently hospitalized.* To estimate the numbers, percentages, and rates of falls and fall injuries among older adults by selected characteristics and state, CDC analyzed data from the 2014 Behavioral Risk Factor Surveillance System (BRFSS) survey. In 2014, 28.7% of older adults reported falling; the estimated 29.0 million falls resulted in 7.0 million injuries. Known effective strategies for reducing the number of older adult falls include a multifactorial clinical approach (e.g., gait and balance assessment, strength and balance exercises, and medication review). Health care providers can play an important role in fall prevention by screening older adults for fall risk, reviewing and managing medications linked to falls, and recommending vitamin D supplements to improve bone, muscle, and nerve health and reduce the risk for falls.

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Author and article information

Contributors

Lu Peng: yuexiangzi@163.com

Lili Deng: denglili@gzucm.edu.cn

Journal

Journal ID (nlm-ta): BMC Public Health

Journal ID (iso-abbrev): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2458

Publication date (Electronic): 16 February 2024

Publication date PMC-release: 16 February 2024

Publication date Collection: 2024

Volume: 24

Electronic Location Identifier: 499

Affiliations

[1 ]The Second Clinical College of Guangzhou University of Chinese Medicine, ( https://ror.org/03qb7bg95) Guangzhou, China

[2 ]School of Nursing, Hunan University of Chinese Medicine, ( https://ror.org/02my3bx32) Changsha, China

[3 ]The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Traditional Chinese Medicine), ( https://ror.org/01gb3y148) Guangzhou, China

Article

Publisher ID: 17982

DOI: 10.1186/s12889-024-17982-4

PMC ID: 10873935

PubMed ID: 38365639

SO-VID: b92cd3e6-1e27-4d29-95e9-eb67fa123fa2

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 13 September 2023

Date accepted : 4 February 2024

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100012151, Sanming Project of Medicine in Shenzen Municipality;

Award ID: No. SZZYSM202206014

Funded by: FundRef http://dx.doi.org/10.13039/100012829, Guangdong Provincial Hospital of Traditional Chinese Medicine;

Award ID: No. YN2022HL21

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ScienceOpen disciplines: Public health

Keywords: falls accident,chronic kidney disease,charls,psm

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ScienceOpen disciplines: Public health

Keywords: falls accident, chronic kidney disease, charls, psm

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Development and validation of prediction model for fall accidents among chronic kidney disease in the community
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Risk of fall in patients with chronic kidney disease: results from the China health and retirement longitudinal study (CHARLS)

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Abstract

Background

Methods

Results

Conclusions

Supplementary Information

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Jiangsu Journal of Preventive Medicine

Most cited references 30

Global Prevalence of Chronic Kidney Disease – A Systematic Review and Meta-Analysis

Falls in older people: epidemiology, risk factors and strategies for prevention.

Falls and Fall Injuries Among Adults Aged ≥65 Years - United States, 2014.

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