Pengaruh Kadar Vitamin D dengan Risiko Jatuh pada Pasien Lansia Penyakit Ginjal Kronik yang Menjalani Hemodialisa Reguler

Abstract

Introduction Ageing is a biological process in which physiological changes occur in the body. Elderly individuals experience changes in the function of cells, tissues, organs and body systems. Falls are one of the main causes of falls in the elderly due to a number of factors including gait disturbance, balance disturbance, visual impairment, chronic kidney disease (CKD) and vitamin D deficiency, among others. Chronic kidney disease can lead to disruption of vitamin D metabolism especially in the elderly population. Although vitamin D deficiency has been associated with falls in the elderly, very few studies in Indonesia have focused on vitamin D deficiency and falls risk in CKD patients on haemodialysis. This study aims to assess the relationship between vitamin D status and the risk of falls in elderly patients with chronic kidney disease who receive regular haemodialysis. Methods This study is a cross-sectional study by assessing the relationship between vitamin D status and the risk of falls in elderly patients undergoing regular haemodialysis at H. Adam Malik General Hospital and Rasyida Kidney Special Hospital Medan. Fall risk assessment was conducted using the Morse Fall Scale (MFS) and vitamin D status was examined at the Clinical Pathology Laboratory of H. Adam Malik Hospital Medan. Data were statistically tested using Chi Square method. Results This study found 92 subjects with a median vitamin D level of 20.15 (3.9-52.1) mg/dL and a median MFS score of 65 (25-95). A total of 87% of the subjects had deficient vitamin D levels, 11% of the subjects were inadequate, and 1% of the subjects had adequate vitamin D levels. 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 association between vitamin D status and fall risk with a p value of 0.001 and an odds ratio of 0.056 (95% CI 0.008-0.454). Conclusion Decreased Vitamin D levels in the body have a significant relationship with the risk of falls in elderly patients with CKD who undergo regular haemodialysis.