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Abstract: TH-PO252

Fall Risks in Chronic Hemodialysis and Peritoneal Dialysis Patients in the United States (2006-2016)

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Zhao, Xinju, Peking University People's Hospital, Beijing, China
  • Han, Yun, University of Michigan, Ann Arbor, Michigan, United States
  • Bragg-Gresham, Jennifer L., University of Michigan, Ann Arbor, Michigan, United States
  • He, Kevin, Kidney Epidemiology and Cost Center, University of Michgian, Ann Arbor, Michigan, United States
  • Zuo, Li, Peking University People's Hospital, Beijing, China
  • Saran, Rajiv, University of Michigan, Ann Arbor, Michigan, United States
Background

Patients with end stage kidney disease (ESKD) have a substantially higher risk of falls, but the burden of fall events has not been sufficiently characterized in this population. We compared trends in minor and major fall rates in both hemodialysis (HD) and peritoneal dialysis (PD) patients in the US between 2006 and 2016.

Methods

Analysis included 4,766,341 dialysis patients (HD: 4,343,752; PD: 422,589) in the US Renal Data System database (2006-2016). ICD-CM diagnosis codes were used to identify major and minor falls. Major falls included those in combination with fractures, brain injuries, or joint and ligament dislocation. Minor falls included falls without these complications. Fall rates expressed per 1000 patient-years (py) were calculated and patient characteristics compared for both types of falls by dialysis modality.

Results

Overall, HD patients were older and more likely to be male compared with PD patients (mean age: 63.6 vs 57.5 years, male: 56.3% vs 54.7%). Over the past decade, patients on HD experienced higher rates of both major and minor falls than those on PD (Figure 1). The rate of major falls gradually decreased from 2006-2014, and grew substantially after 2014 among both populations (HD vs PD: 227 vs 157 per 1000 py in 2016). There was a notable increase in the rate of minor falls among both populations during the period from 2006-2016 (HD: 125 to 190 per 1000 py; PD: 66 to 119 per 1000 py). Patients who were female, white, age >45 years and prevalent dialysis patients had a higher risk of falls than their counterparts who were male, other ethnicity origins, age ≤45 and incident dialysis patients.

Conclusion

Fall risk is high for the ESKD population, especially among those undergoing HD, aged >45years, white, female and prevalent dialysis. Falls are a safety issue can cause serious injuries with resultant complications along with increased resource utilization. Further research and implementation projects designed to lower fall risk among ESKD patients are urgently warranted.

Funding

  • NIDDK Support