Factors associated with falls in hemodialysis patients: a case-control study.

Small retrospective study of 31 patients from a single hospital, so chance and setting-specific factors are likely. Cases were defined by self-reported falls in the previous 6 months, and the exact time and circumstances of falls outside the hospital were not recorded. Balance tests were done 6 months earlier before and after one dialysis session, not at the time of a fall, so the temporal link is unclear. The study examined many laboratory, medication, dialysis and balance variables at once, so the contribution of any single factor cannot be separated. Patients with central neurological, vestibular, uncorrected visual, locomotor deformity or inability to stand were excluded, so results may not apply to all dialysis patients. Dialysis-related amyloidosis and joint or nervous system involvement were not assessed, so the meaning of higher beta-2 microglobulin is uncertain.

Do not conclude that reducing weight change or stopping antihypertensives or beta-2 antagonists prevents falls. The study compared fallers and non-fallers after the fact, so it cannot show that any single factor caused falls.