Equilíbrio postural em pacientes renais crônicos submetidos à hemodiálise comparados a indivíduos sem doença renal crônica: estudo transversal

Abstract

Introduction: Patients with chronic kidney disease (CKD) in hemodialysis (HD) present several factors that contribute to postural balance impairment and can increase risk of falls. Objectives: To compare postural balance and fear of falling between patients in HD and subjects without CKD, as well as verify the factors correlated with postural balance and fear of falling. Methods: A cross-sectional study was conducted, approved in ethics and research committee, including a group of patients with CKD in HD (HG) (n = 39, 55 ± 8 years, 54% males) and a control group (CG) (n = 39, 55 ± 8 years, 54% male). Participants were submitted to the following evaluations: postural balance (Mini Balance Evaluation Systems Test) and fear of falling (Falls Efficacy Scale-International), in addition to functional mobility (Timed Up and Go), gait speed (Gait Speed Measured over 4 m), muscle strength (handgrip and 10 repetition sit-to-stand test) and quality of life (36-Item Short Form Survey) questionnaires were also applied. Results: GH showed worse postural balance [22 (3) vs. 24 (2), p < 0.001] and greater fear of falling [25 (10) vs. 23 (6), p = 0.003] when compared to GC. Postural balance correlated significantly with gait speed ( = 0.381, p = 0.017) and muscle strength ( = -0.358, p = 0.027), and fear of falling correlated with phosphorus ( = - 0.342; p = 0.033), paratormonium ( = 0.438; p = 0.006), muscle strength ( = 0.424, p = 0.008) and quality of life [physical functioning ( = -0.649; p < 0.001), vitality ( = -0.373; p = 0.019), role physical ( = -0.383; p = 0.016), role emotional ( = -0.319; p = 0.048), pain ( = -0.357; p = 0.026)]. Conclusion: In the present study, patients in HD showed worse postural balance and greater fear of falling than subjects without CKD. Postural balance correlated with physical assessments, while fear of falling correlated with clinical, physical and mental parameters.