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Epidemiology of falls and fall-related injuries among middle-aged adults with kidney disease

Abstract

Purpose

Comorbidities, such as kidney disease (CKD), increase the likelihood of falls and fall-related injuries. Despite the focus of most research in this population on older adults, falls are a significant cause of injury throughout adulthood. Therefore, we aimed to describe the epidemiology of falls in middle-aged adults with kidney diseases.

Methods

We analyzed falls and fall-related injuries among middle-aged adults (45–65 years old) with and without CKD included in the 2014 Behavioral Risk Factor Surveillance System (BRFSS) utilizing multivariate logistic regression and complex sample survey data analysis procedures.

Results

Middle-aged adults with CKD were more likely to suffer a fall (2.30, 95% CI 2.07–2.55) and a fall-related injury (1.54, 95% CI 1.32–1.80) compared to those without CKD. However, only the increased likelihood for falls remained significant after correction for multiple demographic, health, lifestyle, and comorbid conditions (AOR 1.22, 95% CI 1.08–1.39). Among adults with CKD, general health status, smoking, and total comorbidity scores were significant predictors of falls and fall-related injuries (p < 0.05 for all). Furthermore, individual comorbidities such as COPD, asthma, depressive disorders, stroke, and arthritis also predicted falls and fall-related injuries (p < 0.05 for all).

Conclusion

Middle-aged adults with CKD were more likely than those without CKD to fall and suffer a fall-related injury. However, injury risk did not remain elevated after accounting for differences between groups. The presence of comorbidities, especially depressive disorders, was associated with increased odds for falls and fall-related injuries. Given the high prevalence of depression among adults with CKD, the relationship between depression and falls warrants further examination.

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Correspondence to Brandon M. Kistler.

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This study involved de-identified and publically available secondary data. However, all procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

BMK is a consultant for the Academy of Nutrition and Dietetics. JK, KW, and MW declare no conflicts of interest. JS has received funding from the National MS society, National Institutes of Health, Permobile, Inc., and Johnson & Johnson, Inc. JS has consulted for AbbVie and is the owner of Sosnoff Technologies, Inc.

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Kistler, B.M., Khubchandani, J., Wiblishauser, M. et al. Epidemiology of falls and fall-related injuries among middle-aged adults with kidney disease. Int Urol Nephrol 51, 1613–1621 (2019). https://doi.org/10.1007/s11255-019-02148-8

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Keywords

  • Falls
  • Injury
  • Kidney disease
  • Renal disease
  • Balance
  • Trauma