Department of Internal Medicine, Faculty of Medicine Universitas Indonesia
Doi
Abstract
Introduction. Fall is one of the main causes of hospitalization in the elderly, which is caused by several factors including
gait disturbances, balance disorders, visual disturbances, chronic kidney disease (CKD), vitamin D deficiency, and so on.
Chronic kidney disease can cause disruption of vitamin D metabolism, especially in the elderly population. This study aimed
to assess the relationship between vitamin D status and the risk of falling in elderly patients with CKD who receive regular
hemodialysis programs.
Methods. We conducted a cross-sectional study by assessing the relationship between vitamin D status and the risk of fall
in elderly patients undergoing regular hemodialysis at H. Adam Malik General Hospital and Rasyida Kidney Special Hospital
Medan. Fall risk assessment was carried out using the Morse fall scale (MFS) and vitamin D status was examined in the
Clinical Pathology Laboratory of H. Adam Malik General Hospital, Medan. The data was analyzed statistically with the chi
square test.
Results. This study involved 92 subjects with a median vitamin D level of 20.15 (3.9-52.1) mg/dL and a median MFS value of
65 (25-95). As many as 87% of subjects had insufficient vitamin D levels, 11% of subjects had inadequate levels, and 1% of
subjects had adequate levels of vitamin D. High fall risk was found in 56% of subjects, 43% had moderate fall risk, and 1%
had low fall risk. The chi square test found a significant relationship between vitamin D status and risk of falling with p value
= 0.001 and an odds ratio 0.056 (95%CI 0.007-0.454).
Conclusion. Reduction of vitamin D level has a significant relationship with the risk of falling in elderly patients with CKD
undergoing regular hemodialysis
