{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"submitter":["Bowling CB"],"funding":["NIA NIH HHS","AHRQ HHS","NHLBI NIH HHS","NINDS NIH HHS","NIAMS NIH HHS","CSRD VA"],"pagination":["1236-43"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC4934847"],"repository":["biostudies-literature"],"omics_type":["Unknown"],"volume":["11(7)"],"pubmed_abstract":["<h4>Background and objectives</h4>Falls are common and associated with adverse outcomes in patients on dialysis. Limited data are available in earlier stages of CKD.<h4>Design, setting, participants, & measurements</h4>We analyzed data from 8744 Reasons for Geographic and Racial Differences in Stroke Study participants ≥65 years old with Medicare fee for service coverage. Serious fall injuries were defined as a fall-related fracture, brain injury, or joint dislocation using Medicare claims. Hazard ratios (HRs) for serious fall injuries were calculated by eGFR and albumin-to-creatinine ratio (ACR). Among 2590 participants with CKD (eGFR<60 ml/min per 1.73 m(2) or ACR≥30 mg/g), cumulative mortality after a serious fall injury compared with age-matched controls without a fall injury was calculated.<h4>Results</h4>Overall, 1103 (12.6%) participants had a serious fall injury over 9.9 years of follow-up. The incidence rates per 1000 person-years of serious fall injuries were 21.7 (95% confidence interval [95% CI], 20.3 to 23.2), 26.6 (95% CI, 22.6 to 31.3), and 38.3 (95% CI, 31.2 to 47.0) at eGFR levels ≥60, 45-59, and <45 ml/min per 1.73 m(2), respectively, and 21.3 (95% CI, 20.0 to 22.8), 31.7 (95% CI, 27.5 to 36.5), and 42.2 (95% CI, 31.3 to 56.9) at ACR levels <30, 30-299, and ≥300 mg/g, respectively. Multivariable adjusted HRs for serious fall injuries were 0.91 (95% CI, 0.76 to 1.09) and 1.09 (95% CI, 0.86 to 1.37) for eGFR=45-59 and <45 ml/min per 1.73 m(2), respectively, versus eGFR≥60 ml/min per 1.73 m(2) and 1.31 (95% CI, 1.11 to 1.54) and 1.81 (95% CI, 1.30 to 2.50) for ACR=30-299 and ≥300 mg/g, respectively, versus ACR<30 mg/g. Among participants with CKD, cumulative 1-year mortality rates among patients with a serious fall and age-matched controls were 21.0% and 5.5%, respectively.<h4>Conclusions</h4>Elevated ACR but not lower eGFR was associated with serious fall injuries. Evaluation for fall risk factors and fall prevention strategies should be considered for older adults with elevated ACR."],"journal":["Clinical journal of the American Society of Nephrology : CJASN"],"pubmed_title":["Association of Reduced eGFR and Albuminuria with Serious Fall Injuries among Older Adults."],"pmcid":["PMC4934847"],"funding_grant_id":["U01 NS041588","R03 AG042336","K12 HS023009","K24 HL125704","IK2 CX000856","P50 AR060772"],"pubmed_authors":["Muntner P","Judd SE","Bowling CB","Curtis JR","Shimbo D","McClellan W","Reynolds K","Bromfield SG","Gutierrez OM","Wright NC","Warnock DG","Colantonio LD","Franch H"],"additional_accession":[]},"is_claimable":false,"name":"Association of Reduced eGFR and Albuminuria with Serious Fall Injuries among Older Adults.","description":"<h4>Background and objectives</h4>Falls are common and associated with adverse outcomes in patients on dialysis. Limited data are available in earlier stages of CKD.<h4>Design, setting, participants, & measurements</h4>We analyzed data from 8744 Reasons for Geographic and Racial Differences in Stroke Study participants ≥65 years old with Medicare fee for service coverage. Serious fall injuries were defined as a fall-related fracture, brain injury, or joint dislocation using Medicare claims. Hazard ratios (HRs) for serious fall injuries were calculated by eGFR and albumin-to-creatinine ratio (ACR). Among 2590 participants with CKD (eGFR<60 ml/min per 1.73 m(2) or ACR≥30 mg/g), cumulative mortality after a serious fall injury compared with age-matched controls without a fall injury was calculated.<h4>Results</h4>Overall, 1103 (12.6%) participants had a serious fall injury over 9.9 years of follow-up. The incidence rates per 1000 person-years of serious fall injuries were 21.7 (95% confidence interval [95% CI], 20.3 to 23.2), 26.6 (95% CI, 22.6 to 31.3), and 38.3 (95% CI, 31.2 to 47.0) at eGFR levels ≥60, 45-59, and <45 ml/min per 1.73 m(2), respectively, and 21.3 (95% CI, 20.0 to 22.8), 31.7 (95% CI, 27.5 to 36.5), and 42.2 (95% CI, 31.3 to 56.9) at ACR levels <30, 30-299, and ≥300 mg/g, respectively. Multivariable adjusted HRs for serious fall injuries were 0.91 (95% CI, 0.76 to 1.09) and 1.09 (95% CI, 0.86 to 1.37) for eGFR=45-59 and <45 ml/min per 1.73 m(2), respectively, versus eGFR≥60 ml/min per 1.73 m(2) and 1.31 (95% CI, 1.11 to 1.54) and 1.81 (95% CI, 1.30 to 2.50) for ACR=30-299 and ≥300 mg/g, respectively, versus ACR<30 mg/g. Among participants with CKD, cumulative 1-year mortality rates among patients with a serious fall and age-matched controls were 21.0% and 5.5%, respectively.<h4>Conclusions</h4>Elevated ACR but not lower eGFR was associated with serious fall injuries. Evaluation for fall risk factors and fall prevention strategies should be considered for older adults with elevated ACR.","dates":{"release":"2016-01-01T00:00:00Z","publication":"2016 Jul","modification":"2025-04-22T02:21:05.503Z","creation":"2019-03-27T02:17:41Z"},"accession":"S-EPMC4934847","cross_references":{"pubmed":["27091516"],"doi":["10.2215/cjn.11111015","10.2215/CJN.11111015"]}}