HONOLULU, Hawaii—The increased risk of falls associated with creatinine clearance (CrCl) of less than 65 mL/min in elderly subjects is at least partly due to decreased balance and muscle strength, Laurent C. Dukas, MD, MPH, reported at the American Society of Bone and Mineral Research 29th Annual Meeting.¹ Dr. Dukas is with the Geriatric University Clinic, Kantonsspital, in Basel, Switzerland.

"[T]he increased risk for falls observed with a low creatinine clearance can, at least partly, be explained by reduced muscle power and balance, most probably due to a low creatinine clearance-induced decreasing calcitriol serum level," Dr. Dukas said.

This cross-sectional study from seven European countries included 1190 women and 127 men aged 60 or older with mean body mass index of 27.2 kg/m² and mean CrCl of 58.6 mL/min. Of these participants, 861 (65.4%) had CrCl <65 mL/min, and women were significantly more likely than men to have reduced CrCl. Balance and muscle power were measured with the timed up-and-go (TUG) test, the tandem stand test (TST), and the chair rising test (CRT).

Dr. Dukas reported that decreasing CrCl was significantly associated with lower performance in the TUG test and CRT but not in the TST. The correlation was independent of gender.

Compared with subjects with CrCl of >e;65 mL/min, those with more impaired renal function had TUG of 15.8 versus 14.3 seconds (P <.0001) and CRT of 17 versus 16 seconds (P <.0001).

"A creatinine clearance of less than 65 mL/min is also in this population significantly associated with an increased risk for falls," Dr. Dukas said.

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