Gender-Based Differences In Dynamic Balance Among Hemodialysis Patients

Aim of the study is to investigate gender-based differences in dynamic balance in form of Timed-Up-and-Go and Five Times-sit-to-Stand-to-sit tests among hemodialysis patients. The main question it aims to answer is:

Are there gender-based differences in dynamic balance in form of Timed-Up-and-Go and Five Times-sit-to-Stand-to-sit tests among hemodialysis patients?

Study Overview

• Status: Not yet recruiting
• Conditions: Hemodialysis Patient

Detailed Description

Kidney disease is a prevalent renal disorder affecting a significant proportion of the global population, creating major challenges for health, quality of life and economic burden. Kidney disease is characterized by an irregularity in kidney structure or function that may manifest suddenly and can either resolve or progress to a chronic state. Chronic Kidney Disease (CKD) is a broad term for several illnesses characterized by varied clinical manifestations with kidney failure being the most severe consequence, demanding treatment only through dialysis or transplantation.

Hemodialysis is characterized by the diffusion of solutes via a semipermeable membrane, with the objective of restoring the homeostatic balance of intracellular and extracellular fluids, as typically regulated by healthy kidneys. Although hemodialysis is essential for life in patients with advanced CKD, it is associated with significant impairments in balance.

Several studies have consistently shown that individuals receiving hemodialysis suffer from balance control deficits. These include greater postural sway, diminished dynamic stability, and slow prolonged sit-to-stand performance, even in individuals who self-report satisfactory physical function.

Balance impairment in hemodialysis patients is attributed to proprioceptive sensory impairments, diminished lower-limb muscle strength, and neuromuscular dysfunction. Moreover, high-risk sarcopenia has been demonstrated to connect with compromised dynamic balance, evidenced by reduced gait speed, diminished stride length, extended double support phase, and elevated Timed-Up-and-Go (TUG) test durations.

Balance is typically classified into static balance and dynamic balance. Both are affected in active hemodialysis patients but impairment in dynamic balance is a more important predictor of accidental falls in these patients .

Falls are a major health concern among hemodialysis patients, with a prevalence significantly higher than that in the general population. 27.1% of hemodialysis patients experience falls. Among those followed up for over 12 months, the rate rises to 28.8%, with 14.8% having repeated falls. Significantly, despite the patients' young age, their risk of repeated falls was equivalent to that commonly observed in older persons, highlighting the significant fall risk linked to hemodialysis regardless of age. Falls in hemodialysis patients increase the risk of injury, reduce quality of life, and contribute to higher mortality rates. These findings emphasize the importance of routinely assessing motor function as part of comprehensive healthcare for hemodialysis patients to better develop interventions and improve patient outcomes.

Considering the significant implications of dynamic balance impairment, it is essential to examine aspects such as gender differences, which may affect dynamic balance performance and total motor function in hemodialysis patients.

• Study Type: Observational
• Enrollment (Estimated): 155

Contacts and Locations

• Study Contact: Name: Nada Elmetwaly Elbatal, MSc candidate; Phone Number: +0201002122931 +201002122937; Email: nadaelbatal98@gmail.com
• Study Contact Backup: Name: Tasneem Ehab Mohammed, PhD; Phone Number: +20103348580; Email: Tasneem_ehab@cu.edu.eg

Study Locations

• Egypt
  • Tanta, Egypt
    • Tanta General Hospital
    • Contact: Rasha Abdelbaath Elgammal, MD; Phone Number: +01069845306; Email: rashaabd8@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The study will be conducted on 155 hemodialysis patients divided into 2 study groups; group A (62 female patients) and group B (93 male patients). Patients with age ranged from 20 to 60 years old and BMI from 18.5 to 29.9 kg/m2. All patients have been undergoing hemodialysis three times per week for at least 1 year; without secondary disorders that may affect balance assessment.

Description

Inclusion Criteria:

• Age 20 to 60 years (both sexes)
• Body mass index (BMI) 18.5 to 29.9 kg/m²
• Undergoing hemodialysis three times per week
• Duration of hemodialysis ≥1 year
• No exercise therapy within the last 3 months
• Able to walk independently for at least 2 minutes without assistive devices

Exclusion Criteria:

• Recent myocardial infarction (within 6 weeks)
• Malignant arrhythmia or unstable angina
• History of major surgery or fracture of the hip/knee, or hip/knee replacement
• Severe respiratory or cardiovascular conditions affecting cardiopulmonary function
• Severe hypotension during or after hemodialysis
• Neurological disorders affecting balance

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Male Hemodialysis Patients; Group 1 Name: Male Hemodialysis Patients Description: Male patients undergoing maintenance hemodialysis 3 times per week who will be assessed for dynamic balance using the Timed Up and Go and Five Times Sit-to -Stand-to-Sit tests.
Female Hemodialysis Patients; Group 2 Name: Female Hemodialysis Patients Description: Female patients undergoing maintenance hemodialysis 3 times per week who will be assessed for dynamic balance using the Timed Up and Go and Five Times Sit-to -Stand-to-Sit tests.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Dynamic Balance among Hemodialysis Patients	Assessed using Timed-Up-and-Go test . Each participant will perform the Timed-Up-and-Go test twice, and the shortest completion time (in seconds) will be recorded.	At baseline (single assessment)

Collaborators and Investigators

• Sponsor: Cairo University

Publications and helpful links

General Publications

• Blake C, O'Meara YM. Subjective and objective physical limitations in high-functioning renal dialysis patients. Nephrol Dial Transplant. 2004 Dec;19(12):3124-9. doi: 10.1093/ndt/gfh538. Epub 2004 Oct 19.

Helpful Links

• Related Info

Study record dates

Study Major Dates

• Study Start (Estimated): April 16, 2026
• Primary Completion (Estimated): May 15, 2026
• Study Completion (Estimated): May 25, 2026

Study Registration Dates

• First Submitted: April 14, 2026
• First Submitted That Met QC Criteria: April 24, 2026
• First Posted (Actual): April 29, 2026

Study Record Updates

• Last Update Posted (Actual): April 29, 2026
• Last Update Submitted That Met QC Criteria: April 24, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Balance
• Other Study ID Numbers: HD-Balance-Gender-2026

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No