Haemodialysis patients have worse postural balance with an associated risk of falls.

Abstract Introduction Postural balance is the result of a complex interaction of sensory input which keeps us upright. Haemodialysis patients have alterations which can lead to postural instability and a risk of falls. Our objective was to analyse postural stability and its relationship with the risk of falls in haemodialysis patients using a force platform. Material and methods This was a prospective cross-sectional study. Postural balance was recorded using a force platform in prevalent haemodialysis patients. We collected epidemiological, dialysis, analytical and treatment data. The incidence of falls was recorded over the six months following the tests. The postural stability analysis was performed with a portable strain gauge platform (AMTI AccuGait®) and a specific software unit for stabilometry (Balance Trainer® program). We measured 31 balance parameters; the balance variables used were: Area95; Area effect; VyMax; Xrange and Yrange. The stabilometry studies were performed in three situations: with eyes open (EO); with eyes closed (EC); and with the patient performing a simultaneous task (COG). We performed one study at the start of the dialysis session, and a second study at the end. Stabilometry was measured in a control group under similar conditions. Results We studied 32 patients with a mean age of 68 years old; of this group, 20 subjects were male and 12 were female. Their mean weight was 74 kg, with a mean BMI of 27.6 kg/m2. In the controls, there were no significant differences in the stabilometry between the three situations studied. Both pre- and post-haemodialysis, patients with closed eyes showed greater imbalance, and there were significant differences with the other situations and controls. We found a significant increase in instability after the haemodialysis session, and greater instability in the 13 patients with diabetes (p  Conclusions Haemodialysis patients have alterations which can lead to postural instability and a risk of falls. Prevention programmes which include specific exercises to improve balance could be beneficial in reducing the risk of falls in this population.