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. 2018 Nov 28;7(12):493.
doi: 10.3390/jcm7120493.

The Number of Comorbidities Predicts Renal Outcomes in Patients with Stage 3⁻5 Chronic Kidney Disease

Wen-Chin Lee  1 , Yueh-Ting Lee  2 , Lung-Chih Li  3 , Hwee-Yeong Ng  4 , Wei-Hung Kuo  5 , Pei-Ting Lin  6 , Ying-Chun Liao  7 , Terry Ting-Yu Chiou  8 , Chien-Te Lee  9
Affiliations

The Number of Comorbidities Predicts Renal Outcomes in Patients with Stage 3⁻5 Chronic Kidney Disease

Wen-Chin Lee et al. J Clin Med. .

Abstract

Background: Chronic kidney disease (CKD) is a global health threat affecting approximately 10% of the adult population worldwide. Multimorbidity is common in CKD, but its impacts on disease outcomes are seldom investigated.

Methods: This prospective cohort analysis followed patients, who were part of a multidisciplinary CKD care program, for 10 years. We aimed to determine the impact of multimorbidity on renal outcomes.

Results: Overall, 1463 patients with stage 3⁻5 CKD were enrolled and stratified by the number of comorbidities. Mean follow-up time was 6.39 ± 1.19 years. We found that stage 3⁻5 CKD patients with at least three comorbidities at enrollment initiated dialysis earlier (hazard ratio (HR): 2.971) than patients without comorbidities. Risk factors for multimorbidity included old age, smoking, and proteinuria.

Conclusions: By analyzing the number of comorbidities, a simple and readily applicable method, we demonstrated an association between multimorbidity and poor renal outcomes in stage 3⁻5 CKD patients. In addition to current guideline-based approaches, our results suggest an urgent need for tailored CKD care strategies for high-risk groups.

Keywords: chronic kidney disease; multimorbidity; renal outcomes.

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Conflict of interest statement

All authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Kaplan–Meier plots showing cumulative patient (a) and renal (b) survival by comorbidity status.
Figure 2
Figure 2
A number of comorbidities ≥3 was associated with a faster decline of the renal function in patients with stage 3–5 CKD.
See this image and copyright information in PMC

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