The Effect Of Vitamin D Levels With The Risk Of Falling In Elderly Patients With Chronic Kidney Disease Undergoing Regular Hemodialysis

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The Effect of Vitamin D Levels on the Risk of Falling in Elderly Patients with Chronic Kidney Disease Undergoing Regular Hemodialysis

Introduction

Aging is a natural biological process that brings about various physiological changes in the body. Elderly individuals experience changes in the function of cells, tissues, organs, and body systems. One of the common health problems in this age group is the risk of falling, which can be caused by various factors, including current disorders, balance disorders, vision disorders, chronic kidney disease (CKD), and vitamin D deficiency. Chronic kidney disease can significantly interfere with the metabolism of vitamin D, especially in the elderly population. Although vitamin D deficiency has been associated with an increased risk of falling in the elderly, there are still few studies in Indonesia that examine the relationship between vitamin D deficiency and the risk of falling in CKD patients undergoing hemodialysis. Therefore, this study aims to evaluate the relationship between vitamin D status and the risk of falling in elderly patients with chronic kidney diseases that undergo hemodialysis routinely.

The Importance of Vitamin D in Elderly Patients with CKD

Vitamin D plays a crucial role in maintaining bone health, and its deficiency can lead to various health problems, including osteoporosis and muscle weakness. Elderly patients with CKD are at a higher risk of developing vitamin D deficiency due to impaired kidney function. The kidneys are responsible for converting vitamin D into its active form, which is essential for calcium absorption and bone health. With impaired kidney function, the body's ability to convert vitamin D is compromised, leading to a deficiency. This deficiency can contribute to an increased risk of falling in elderly patients with CKD.

Methodology

This study is a cross-sectional study that assesses the relationship between vitamin D status and the risk of falling in elderly patients undergoing routine hemodialysis at H. Adam Malik General Hospital and Kidney Special Hospital in Medan. Falling risk assessment is carried out using the Morse Fall Scale (MFS), while the status of vitamin D is examined in the Pathology Laboratory of H. Adam Malik Hospital Pathology Medan. The data obtained were analyzed statistically using the Chi Square method.

Results

From this study, 92 subjects were found with a median of vitamin D levels of 20.15 (3.9-52.1) Mg/DL and the median MFS score of 65 (25-95). The results show that 87% of the subjects experience vitamin D deficiency, 11% have inadequate vitamin D levels, and only 1% of subjects have sufficient levels of vitamin D. A high level of falling risk is found in 56% of the subject, 43% has a medium fall risk, and 1% has a low falling risk. The Chi Square test shows a significant relationship between vitamin D status and falling risk, with P value of 0.001 and Odds Ratio of 0.056 (95% CI 0.008-0.454).

Conclusion

Decreased levels of vitamin D in the body have a significant relationship with an increased risk of falling in elderly patients with chronic kidney disease undergoing routine hemodialysis. This shows the importance of attention to the status of vitamin D in efforts to prevent falling in the elderly population, especially those who suffer from CKD.

Additional Analysis and Explanation

Low levels of vitamin D in elderly CKD patients can cause various health problems, including osteoporosis and muscle weakness, which contributes to the risk of falling. Vitamin D deficiency can interfere with calcium absorption, which is very important for bone health. With low calcium levels, bone strength will also decrease, thereby increasing the likelihood of fractures if it falls.

The Importance of Monitoring Vitamin D Levels in Elderly Patients with CKD

The importance of monitoring vitamin D levels regularly in elderly patients undergoing hemodialysis must be a major concern for health workers. Handling of vitamin D deficiency through supplementation can be one solution to reduce the risk of falling in these patients. In addition, education regarding handling balances and safe physical activity must also be given to elderly patients to improve their quality of life.

Public Health Implications

In the context of public health, this research confirms the need for comprehensive prevention steps, including routine screening for vitamin D deficiency and physical rehabilitation programs for the elderly, in order to reduce the fall incidents and negative impacts it causes. Early detection and treatment of vitamin D deficiency can help prevent falls and improve the quality of life of elderly patients with CKD.

Recommendations

Based on the findings of this study, the following recommendations are made:

  1. Regular monitoring of vitamin D levels in elderly patients with CKD to prevent falls and improve their quality of life.
  2. Supplementation of vitamin D in patients with deficiency to improve bone health and reduce the risk of falls.
  3. Education and training on handling balances and safe physical activity for elderly patients with CKD to improve their quality of life.
  4. Comprehensive prevention steps, including routine screening for vitamin D deficiency and physical rehabilitation programs for the elderly, to reduce the fall incidents and negative impacts it causes.

By implementing these recommendations, healthcare providers can help reduce the risk of falls in elderly patients with CKD and improve their quality of life.
Frequently Asked Questions (FAQs) about Vitamin D and Falling Risk in Elderly Patients with Chronic Kidney Disease

Q: What is the relationship between vitamin D levels and falling risk in elderly patients with chronic kidney disease?

A: Vitamin D deficiency has been associated with an increased risk of falling in elderly patients with chronic kidney disease. This is because vitamin D plays a crucial role in maintaining bone health, and its deficiency can lead to osteoporosis and muscle weakness, which contributes to the risk of falling.

Q: How common is vitamin D deficiency in elderly patients with chronic kidney disease?

A: According to our study, 87% of the subjects experience vitamin D deficiency, 11% have inadequate vitamin D levels, and only 1% of subjects have sufficient levels of vitamin D.

Q: What are the consequences of vitamin D deficiency in elderly patients with chronic kidney disease?

A: Vitamin D deficiency can lead to various health problems, including osteoporosis and muscle weakness, which contributes to the risk of falling. Additionally, vitamin D deficiency can interfere with calcium absorption, which is very important for bone health.

Q: How can healthcare providers prevent falls in elderly patients with chronic kidney disease?

A: Healthcare providers can prevent falls in elderly patients with chronic kidney disease by:

  1. Regularly monitoring vitamin D levels to prevent falls and improve their quality of life.
  2. Supplementing vitamin D in patients with deficiency to improve bone health and reduce the risk of falls.
  3. Educating and training patients on handling balances and safe physical activity to improve their quality of life.
  4. Implementing comprehensive prevention steps, including routine screening for vitamin D deficiency and physical rehabilitation programs for the elderly, to reduce the fall incidents and negative impacts it causes.

Q: What are the public health implications of this study?

A: This study confirms the need for comprehensive prevention steps, including routine screening for vitamin D deficiency and physical rehabilitation programs for the elderly, to reduce the fall incidents and negative impacts it causes.

Q: What are the recommendations for healthcare providers based on this study?

A: Based on the findings of this study, the following recommendations are made:

  1. Regular monitoring of vitamin D levels in elderly patients with CKD to prevent falls and improve their quality of life.
  2. Supplementation of vitamin D in patients with deficiency to improve bone health and reduce the risk of falls.
  3. Education and training on handling balances and safe physical activity for elderly patients with CKD to improve their quality of life.
  4. Comprehensive prevention steps, including routine screening for vitamin D deficiency and physical rehabilitation programs for the elderly, to reduce the fall incidents and negative impacts it causes.

Q: What are the limitations of this study?

A: This study has several limitations, including:

  1. Small sample size: The study only included 92 subjects, which may not be representative of the larger population.
  2. Cross-sectional design: The study was conducted at a single point in time, which may not capture the dynamic nature of vitamin D levels and falling risk in elderly patients with CKD.
  3. Limited generalizability: The study was conducted in a specific population (elderly patients with CKD) and may not be generalizable to other populations.

Q: What are the future directions for research on vitamin D and falling risk in elderly patients with chronic kidney disease?

A: Future research should focus on:

  1. Longitudinal studies: Conducting longitudinal studies to capture the dynamic nature of vitamin D levels and falling risk in elderly patients with CKD.
  2. Large sample size: Conducting studies with larger sample sizes to increase the generalizability of the findings.
  3. Multicenter studies: Conducting multicenter studies to increase the diversity of the population and reduce the risk of bias.
  4. Intervention studies: Conducting intervention studies to evaluate the effectiveness of vitamin D supplementation and other interventions in reducing the risk of falls in elderly patients with CKD.