Characteristics of Accidental Falls in the Patients with Chronic Kidney Diseases: A 14-Year Retrospective Study and Review

Background: Accidental falls pose a high-risk that should not be overlooked in patients with chronic kidney disease (CKD), as they can result in significant injury or even fatality. This study aimed to investigate the characteristics of CKD patients with fall injuries during hospitalization, discuss potential mechanisms, and to provide an overview of existing prevention methods. Methods: Falls of all patients in our Nephrology ward from 2009 to 2022 were recorded and counted. 48 patients were enrolled. Patient characteristics, injury distribution, cause of fall injury, relevant blood biochemical indicators, and recovery conditions were counted. Results: There were 22,053 hospitalized patients during the study period, with a fall rate of approximately 0.218%. Patients are prone to involuntary falls due to muscle weakness and confusion during nighttime and early morning activities. Injuries are mainly to the head and there is a risk of serious injury and fracture. CKD is associated with anemia, hypertension, water-electrolytes imbalance and secondary hyperparathyroidism. Blood tests showed that patients commonly had anemia, malnutrition, low immunity, as well as abnormal muscle and neuromodulatory ion levels, such as low calcium, low potassium and high phosphorus. Moreover, Patients usually have low blood pressure control ability. Conclusion: Long-term CKD may lead to subjective dysfunction and motor dysfunction by inducing anemia, malnutrition, water-electrolytes imbalance, and blood pressure control ability, thus making patients prone to falls. This study has important implications for hospital ward safety management and fall prevention in CKD patients. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This research was funded by Shenzhen Science and Technology Innovation Commission (JCYJ20220530150412026), Shenzhen San-Ming Project of Medicine (SZSM201812097) and Shenzhen Clinical Research Center for Urology and Nephrology. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Studies that use electronic health records. Ethics committee/IRB of Peking University Shenzhen Hospital gave ethical approval for this work (No. 2023-064). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors.