Böbrek Nakli Alıcılarında Düşme: Geleneksel Derleme

Abstract

Kidney transplantation is the gold standard treatment for end stage renal disease. Despite the improvement in survival and quality of life, the prevalence of falls is higher in kidney transplant recipients. Factors that increase the risk for falls include female gender, older age, impaired balance control, lower ankle dorsiflexion muscle strength, high serum creatinine levels, and the use of antidiabetic medications. Functional limitations, fatigue, low cardio-respiratory fitness, changes in mineral metabolism lead to bone mineral disease in chronic kidney disease and can finally play an important role in occurrence of accidental falls in pre-transplantation period. Fractures without dislocations or head injury-related hemorrhages constitute a majority for the serious fall-related injury types. In addition to many factors such as cumulative dose of corticosteroids, younger age at transplantation, hyperparathyroidism, vitamin D deficiency and renal osteodystrophy, risk of falls also contribute to increased post-transplantation bone loss and fracture risk. Hip fractures requiring hospitalization in the post-kidney transplant period are associated with a higher risk of mortality. It is important to understand the underlying mechanisms for falls in kidney transplant recipients in order to prevent severe injuries including fractures and decrease healthcare costs. The awareness of healthcare professionals should be increased for falls in this specific population to design multidisciplinary therapeutic approaches including risk factor assessment, exercise programs and patient and caregiver education not only for kidney transplant recipients but also for the patients waiting on a transplantation list.