• Biljana Teovska University Clinic of Nephrology – Skopje, Macedonia
  • Lada Trjaceska
  • Daniela Mladenovska
  • Vladimir Trajkovski
  • Aleksandar Sikole


Introduction: The aim of this study was to search for predictors of disability among patients treated with hemodialysis.

Material and methods: Disability was assessed with self-reports of activities by Katz, Nagi and Rosow-Breslau (R-B) scale in 134 hemodialysis patients in a cross-sectional study. Sociodemographic, clinical, nutritional and dialysis factors were investigated as influencing factors. Multiple logistic regression analysis was used to identify predictors associated with disability scores.

Results: Mean Katz, Nagi and R-B scores of the study group were: 4.67 ± 8.0, 9.96 ± 7.5, 3.84 ± 2.4, respectively. In the univariate analysis, women, patients who were older than 65, had diabetes, intradialytic hypotension, catheter as vascular access, sensor or loco-motor problems, carpal-tunnel syndrome, cerebrovascular disease and body mass index more than 31kg/m2, had at least one Katz activity impairment. In the multivariate regression model, the older age, female gender, carpal tunnel and catheter presence were the strongest independent predictive markers for Katz impairments. As for Nagi and R-B scales, presence of catheter emerged among the strongest predictors.

Conclusion: Many modifiable factors contribute to disability in hemodialysis patients. Interventions are needed before start of hemodialysis in order to unable development of disability during dialysis treatment.


1. Okada T, Nakao T. Physical functional status and factors contributing to disability in Japanese chronic dialysis patients. Nephrology. 1998 Jun;4(3):195–203
2. Cook WL. And Jassal SV. Functional dependencies among the elderly on hemodialysis Kidney International. 2008;73:1289-95
3. Del Duca GF, Silva MC, Hallal PC. Disability relating to basic and instrumental activities of daily living among elderly subjects. Rev Saude Publica. 2009 Oct;43(5):796-805
4. Murray A, Solid C. The burden of walking disability in U.S. dialysis and CKD patients. United States Renal Data System, Minneapolis Medical Research Foundation, University of Minnesota Twin Cities.
5. Мurray A, Pederson S, Qiu Y, Roberts T, Zaun D. The prevalence of disability in hemodialysis patients. Chronic Disease Research Group, Minneapolis Medical Research Foundation, University of Minnesota Twin Cities.
6. Kooman et al. EBPG guideline on hemodynamic instability. Nephrol Dial Transplant. 2007;22 (2): 75–8
7. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW: Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychosocial function. JAMA.1963; 185: 914–
8. Rosow I, Breslau N: A Guttman health scale for the aged. J Gerontol. 1966. 21:556-
9. Chiu SY, Livneh H, Tsao LL, Tsai TY. Acceptance of disability and its predictors among stroke patients in Taiwan. BMC Neurol. 2013;13:175
10. Lopes AA, Bragg-Gresham JL, Goodkin DA et al. Factors associated with health –related quality of life among hemodialysis patients in the DOPPS. Qual Life Res 2007; 16:54
11. Gagnon et al. Carpal tunnel in hemodialysis patients. CMAJ. 1988;139(15):753-55
12. Cheung et al. Predialysis β₂-М vs. clinical survival of dialysis patients. JASN, 2006;(17): 545-55
How to Cite
TEOVSKA, Biljana et al. PREDICTORS OF DISABILITY IN HEMODIALYSIS PATIENTS. Journal of Morphological Sciences, [S.l.], v. 1, n. 2, p. 65-68, dec. 2018. ISSN 2545-4706. Available at: <>. Date accessed: 23 may 2019.