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Correlates of ADL difficulty in a large hemodialysis cohort.

Publication ,  Journal Article
Kutner, NG; Zhang, R; Allman, RM; Bowling, CB
Published in: Hemodial Int
January 2014

Needing assistance with activities of daily living (ADL) is an early indicator of functional decline and has important implications for individuals' quality of life. However, correlates of need for ADL assistance have received limited attention among patients undergoing maintenance hemodialysis (HD). A multicenter cohort of 742 prevalent HD patients was assessed in 2009-2011 and classified as frail, prefrail and nonfrail by the Fried frailty index (recent unintentional weight loss, reported exhaustion, low grip strength, slow walk speed, low physical activity). Patients reported need for assistance with 4 ADL tasks and identified contributing symptoms/conditions (pain, balance, endurance, weakness, others). Nearly 1 in 5 patients needed assistance with 1 or more ADL. Multivariable analysis showed increased odds for needing ADL assistance among frail (odds ratio [OR] 11.35; 95% confidence interval [CI] 5.50-23.41; P < 0.001) and prefrail (OR 1.93; 95% CI 1.01-3.68; P = 0.046) compared with non-frail patients. In addition, the odds for needing ADL assistance were lower among blacks compared with whites and were higher among patients with diabetes, lung disease, and stroke. Balance, weakness, and "other" (frequently dialysis-related) symptoms/conditions were the most frequently named reasons for ADL difficulty. In addition to interventions such as increasing physical activity that might delay or reverse the process of frailty, the immediate symptoms/conditions to which individuals attribute their ADL difficulty may have clinical relevance for developing targeted management and/or treatment approaches.

Duke Scholars

Published In

Hemodial Int

DOI

EISSN

1542-4758

Publication Date

January 2014

Volume

18

Issue

1

Start / End Page

70 / 77

Location

Canada

Related Subject Headings

  • Weight Loss
  • Urology & Nephrology
  • Retrospective Studies
  • Renal Dialysis
  • Muscle Weakness
  • Middle Aged
  • Male
  • Humans
  • Hand Strength
  • Female
 

Citation

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ICMJE
MLA
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Kutner, N. G., Zhang, R., Allman, R. M., & Bowling, C. B. (2014). Correlates of ADL difficulty in a large hemodialysis cohort. Hemodial Int, 18(1), 70–77. https://doi.org/10.1111/hdi.12098
Kutner, Nancy G., Rebecca Zhang, Richard M. Allman, and C Barrett Bowling. “Correlates of ADL difficulty in a large hemodialysis cohort.Hemodial Int 18, no. 1 (January 2014): 70–77. https://doi.org/10.1111/hdi.12098.
Kutner NG, Zhang R, Allman RM, Bowling CB. Correlates of ADL difficulty in a large hemodialysis cohort. Hemodial Int. 2014 Jan;18(1):70–7.
Kutner, Nancy G., et al. “Correlates of ADL difficulty in a large hemodialysis cohort.Hemodial Int, vol. 18, no. 1, Jan. 2014, pp. 70–77. Pubmed, doi:10.1111/hdi.12098.
Kutner NG, Zhang R, Allman RM, Bowling CB. Correlates of ADL difficulty in a large hemodialysis cohort. Hemodial Int. 2014 Jan;18(1):70–77.
Journal cover image

Published In

Hemodial Int

DOI

EISSN

1542-4758

Publication Date

January 2014

Volume

18

Issue

1

Start / End Page

70 / 77

Location

Canada

Related Subject Headings

  • Weight Loss
  • Urology & Nephrology
  • Retrospective Studies
  • Renal Dialysis
  • Muscle Weakness
  • Middle Aged
  • Male
  • Humans
  • Hand Strength
  • Female