Kidney Week

Abstract: PUB052

Impaired Physical Mobility in Hemodialysis Is Associated with Mortality and Increased Health Care Use

Session Information

• Publication Only

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Cernes, Relu, Edith Wolfson Medical Center, Holon, Tel Aviv District, Israel

Relu Cernes, MD

• Abed El Rahman, Imad, Edith Wolfson Medical Center, Holon, Tel Aviv District, Israel

Imad Abed El Rahman, MD

• Tocut, Milena, Edith Wolfson Medical Center, Holon, Tel Aviv District, Israel

Milena Tocut

• Tsehovsky, Tatyana, Edith Wolfson Medical Center, Holon, Tel Aviv District, Israel

Tatyana Tsehovsky, MA

• Katkov, Anna, Edith Wolfson Medical Center, Holon, Tel Aviv District, Israel

Anna Katkov, MD

• Yosha-Orpaz, Liron, Edith Wolfson Medical Center, Holon, Tel Aviv District, Israel

Liron Yosha-Orpaz, MD, PhD

• Feldman, Leonid, Edith Wolfson Medical Center, Holon, Tel Aviv District, Israel

Leonid Feldman, MD

Background

Patients receiving maintenance hemodialysis have high rate of morbidity and mortality. Impaired physical mobility is common in this population and may serve as a practical marker of frailty and adverse outcomes. This study evaluated the association of impaired physical mobility with mortality and healthcare utilization among patients undergoing chronic hemodialysis.

Methods

We conducted a retrospective observational cohort study including 106 adult patients treated with maintenance hemodialysis and followed between February 2022 and June 2025. Patients were classified as having impaired or preserved mobility, based on routine clinical documentation. The primary outcome was all-cause mortality. Secondary outcomes included number of hospitalizations, average length of hospital stay, and emergency department visits. Survival was evaluated using Kaplan–Meier analysis and log-rank testing. Cox proportional hazards regression was used to assess the association between impaired mobility and mortality with age-adjusted and multivariable models.

Results

Impaired physical mobility was present in 46 patients (43.4%). Patients with impaired mobility were older (76.2 ± 10.9 vs. 69.7 ± 12.8 years, p=0.006), more frequently female (54.4% vs. 28.3%, p=0.007), and had lower serum albumin levels (3.7 ± 0.5 vs. 3.9 ± 0.5 g/dL, p=0.019). Overall mortality was 35.8% and was higher in the impaired mobility group (47.8% vs. 26.7%, p=0.027). Kaplan–Meier survival curves showed significantly reduced survival in patients with impaired mobility (log-rank p=0.015). In age-adjusted Cox regression, impaired mobility remained independently associated with mortality (HR 2.07, 95% CI 1.10–3.91, p=0.025). Patients with impaired mobility had more hospitalizations, longer hospital stays, and more emergency department visits (all p<0.05).

Conclusion

Impaired physical mobility in hemodialysis patients is associated with higher mortality and increased healthcare utilization. Routine functional assessment may help identify high-risk patients for early multidisciplinary interventions.