Ten tips on how to prevent falls in dialysis patients

Abstract Falls are frequent and clinically significant events among patients undergoing dialysis and are associated with fractures, hospitalization, loss of independence, and increased mortality. Despite their clinical importance, fall prevention in this population remains challenging in routine practice because fall risk arises from a complex interaction between general geriatric factors and dialysis-specific conditions. This is a narrative review, and proposes a conceptual framework that integrates general fall-related factors with dialysis-specific contributors, and emphasizes the dynamic nature of fall risk over time. Because fall risk may fluctuate with changes in dialysis conditions, comorbidities, physical function, and activity levels, regular reassessment and longitudinal management are essential. While primarily based on evidence from hemodialysis patients, some aspects are considered applicable to peritoneal dialysis patients as well. Within this framework, we here present 10 practical, clinically oriented tips to support fall prevention in patients undergoing dialysis. These tips address systematic risk assessment, monitoring of hemodynamic instability, individualized exercise and physical activity interventions, environmental and behavioral considerations after dialysis sessions, and the importance of multidisciplinary collaboration. By translating current evidence into actionable clinical guidance, this review aims to support clinicians in integrating fall risk assessment and prevention strategies into routine dialysis care. A structured, multidisciplinary, and continuously adaptive approach may help reduce falls and improve safety and functional outcomes in patients undergoing dialysis.