Faculty Collaboration Database

Dialytic hemodynamics are associated with changes in gait speed. Hemodial Int 2017 Oct;21(4):566-574

Date

11/24/2016

Pubmed ID

27878949

Pubmed Central ID

PMC5440226

DOI

10.1111/hdi.12515

Scopus ID

2-s2.0-85005979499 (requires institutional sign-in at Scopus site)   9 Citations

Abstract

INTRODUCTION: Functional impairment and reduced mobility are prevalent in patients on chronic hemodialysis (HD). The impact of HD on physical performance and mobility needs evaluation.

METHODS: We measured gait speed in a cohort of chronic HD patients both pre and post an HD session. We collected demographic and laboratory data and dialytic hemodynamic parameters for the HD session. Participants completed the Falls Efficacy Scale International (FES-I) survey to assess concern for falling. We used linear regression analysis to tests for associations between our predictor variables of intra-dialytic hemodynamic change and change in gait speed from pre to post HD (primary outcome) and FES-I score (secondary outcome).

FINDINGS: Twenty-eight participants completed the study. The mean (SD) age was 64.0 (10.5) years. The majority were male (71.4%), had hypertension (85.7%) and diabetes (57.1%). The mean (SD) change in gait speed from pre to post dialysis was -0.06 (0.08) m/s. A greater decrease in gait speed was associated with greater decrease in SBP and DBP from pre to post HD (p = 0.02 and p = 0.04, respectively) and greater maximum drop in SBP and DBP during HD (p = 0.01 and p <0.01, respectively). The association between maximum drop in SBP and DBP and gait speed remained significant after adjustment for covariates. There was no association between BP change and FES-I score.

DISCUSSION: Our results suggest that HD patients who have greater decrease in BP during HD are at risk for decreased gait speed post HD.

Author List

Wolfgram DF, Lathara Z, Szabo A, Whittle J

Authors

Zubin T. Lathara MD Assistant Professor in the Medicine department at Medical College of Wisconsin
Aniko Szabo PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Jeffrey Whittle MD Professor in the Medicine department at Medical College of Wisconsin
Dawn Felicity Wolfgram MD Associate Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Cohort Studies
Female
Hemodynamics
Humans
Kidney Failure, Chronic
Male
Middle Aged
Renal Dialysis
Walking Speed