Abstract
Objectives: To establish the prevalence of multimorbidity in people with chronic kidney disease (CKD) stages 1–5 and transiently impaired renal function and identify factors associated with multimorbidity.
Design and setting: Prospective cohort study in UK primary care.
Participants: 861 participants aged 60 and older with decreased renal function of whom, 584 (65.8%) had CKD and 277 (32.2%) did not have CKD.
Interventions: Participants underwent medical history and clinical assessment, and blood and urine sampling.
Primary and secondary outcome measures: Multimorbidity was defined as presence of ≥2 chronic conditions including CKD. Prevalence of each condition, co-existing conditions and multimorbidity were described and logistic regression was used to identify predictors of multimorbidity.
Results The mean (±SD) age of participants was 74±7 years, 54% were women and 98% were white. After CKD, the next most prevalent condition was hypertension (n = 511, 59.3%), followed by obesity (n = 265, 30.8%) ischemic heart disease (n = 145, 16.8%) and diabetes (n = 133, 15.4%). Having two co-existing conditions was most common (27%), the most common combination of which was hypertension and obesity (29%). One or three conditions was the next most prevalent combination (20% and 21% respectively). The prevalence of multimorbidity was 73.9% (95%CI 70.9–76.8) in all participants and 86.6% (95%CI 83.9–89.3) in those with any-stage CKD. Logistic regression found a significant association between increasing age (OR 1.07, 95%CI 1.04–0.10), increasing BMI (OR 1.15, 95%CI 1.10–1.20) and decreasing eGFR (OR 0.99, 95%CI 0.98–1.00) with multimorbidity.
Conclusions This analysis is the first to provide an accurate estimate of the prevalence of multimorbidity in a screened older primary care population living with or at risk of CKD across all stages. Hypertension and obesity were the most common combination of conditions other than CKD that people were living with, suggesting that there may be multiple reasons for closely monitoring health status in individuals with CKD.
| Original language | English |
|---|---|
| Article number | e0245131 |
| Number of pages | 14 |
| Journal | PLoS ONE |
| Volume | 16 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 15 Jan 2021 |
Bibliographical note
Funding Information:This work was supported in the form of funding by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC) awarded to JH and JOM, NIHR Community Healthcare MedTECH and In vitro Diagnostic Cooperative (MIC) awarded to DSL, and an NIHR Academic Clinical Lectureship awarded to CT. This work was also supported partially by the NIHR School for Primary Care Research (SPCR), the NIHR Collaboration for Leadership in Applied Research in Health and Care (CLARHC) Oxford, and the NIHR Oxford Biomedical Research Centre (OUHT BRC) for FDRH. This work is also partially supported by the NIHR Collaboration for Leadership in Applied Research in Health and Care (CLARHC) Oxford for RJM. Thank you to the OxREN Steering Committee members: Professor Maarten Taal, Professor of Medicine, Royal Derby Hospital & University of Nottingham (chair), Dr Simon Fraser, GP, Dr Marion Judd (patient representative), Dr Elizabeth Holloway (patient representative). Staff in Oxford University’s Primary Care Clinical Trials Unit were responsible for trial management (Dr Hannah Swayze and Ms Rebecca Lowe), database development, data entry and cleaning (Dr Sue Smith) and patient recruitment (Heather Rutter).
Publisher Copyright:
© 2021 Hirst et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
ASJC Scopus subject areas
- General
