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Main Risk Factors Related to Activities of Daily Living in Non-Dialysis Patients with Chronic Kidney Disease Stage 3–5: A Case–Control Study

Authors Chang J, Hou WW, Wang YF, Sun QM

Received 10 February 2020

Accepted for publication 11 April 2020

Published 1 May 2020 Volume 2020:15 Pages 609—618


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Zhi-Ying Wu

Jing Chang,* Wen-Wen Hou,* Yan-Fei Wang, Qian-Mei Sun

Department of Internal Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Qian-Mei Sun Email [email protected]

Introduction: Elderly people are at increased risk of falls, disability and death due to reduced functional reserve, decline in multiple systems functions, which affects their activities of daily living (ADL) and eventually develop into frailty. The ADL assessment is conducive to early detection to avoid further serious situations. Previous studies on patients’ activities of daily living with chronic kidney disease (CKD) are mainly focused on dialysis patients. Little information is available on non-dialysis patients.
Patients and Methods: A total of 303 elderly patients with CKD stage 3– 5 who were admitted to our hospital were selected. ADL evaluation was performed on patients at admission, with Barthel index (BI) as the evaluation tool. They were divided into two groups based on BI (≥ 60 and < 60). Demographic information, lifestyle and clinical profile were collected. The risk factors related to ADL were analyzed by univariate and multivariate models.
Results: The data of 303 patients enrolled in this study were analyzed. The average age of patients was 84.48± 7.14 years and 62.05% were male. There were 88 patients (29.04%) in BI < 60 group and 215 patients (70.96%) in the BI ≥ 60 group. The average age of subjects in the two groups was 87.47 ± 5.85 years and 83.26± 7.28 years, respectively. On univariate analysis, ADL impairment was associated with many factors, such as age, body mass index, blood lipid, heart rate, smoking history, Charlson comorbidity index (CCI), hemoglobin, serum albumin, BNP, eGFR, etc. Multivariate logistic regression showed that age (OR 1.08, 95% CI 1.00– 1.17, P=0.0390), Charlson comorbidity index (OR 4.75, 95% CI 1.17– 19.30, P=0.0295), and serum albumin (OR 0.80, 95% CI 0.70– 0.92, P=0.0012) were the independent risk factors of ADL impairment.
Conclusion: Decline of ADL in CKD patients was independently correlated with age, Charlson comorbidity index and serum albumin. ADL and its influential factors in the elderly CKD patients deserve further attention.

Keywords: chronic kidney disease, activities of daily living, risk factors

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