Multimorbidity Involving CKD Markedly Increases Hospitalisation Events

Pavankumar Kamat

November 19, 2021

According to a study published today in  BMC Medicine , the presence of multimorbidity is associated with increased rates of emergency hospitalisation, which go up even further when chronic kidney disease (CKD) is one of the multimorbid conditions.

CKD is a condition of public health concern worldwide and is often accompanied by other long-term conditions (LTCs), which may have resulted in CKD, may have developed as a consequence of CKD or may be unrelated to CKD.

Researchers parallelly analysed data from two cohorts, the UK Biobank and the Secure Anonymised Information Linkage (SAIL) Databank from Wales; 469,339 participants from the UK Biobank and 1,620,490 from the SAIL Databank were included in the analysis.

Compared with participants who had 0 LTCs, those with 4 or more LTCs (excluding CKD) had significantly higher emergency hospitalisation rates, (rate ratio [RR] for UK Biobank, 4.95; 95% CI 4.82 to 5.08) and RR for SAIL, 3.77; 95% CI 3.71 to 3.82). The hospitalisation rates increased further when CKD was one of the LTCs (RR for UK Biobank; 7.83; 95% CI 7.42 to 8.25 and RR for SAIL, 9.92; 95% CI 9.75 to 10.09).

Risk factors for emergency hospitalisation in patients with CKD included advanced CKD stages, age over 60 years, multiple cardiometabolic LTCs, concurrent physical and mental LTCs, and LTCs involving three or more body systems.

One of the authors of the study, Prof Patrick Mark, from the University of Glasgow, said: "For a long time nephrologists have suspected that people with kidney disease are at higher risk of hospitalisation, and now our research confirms this. The clinical team caring for these people should review them regularly, make sure they are on the right medications and pick up illnesses early, hopefully before admission to hospital is needed."

This research was supported by grants from the Medical Research Council and the Swedish Research Council.

Sullivan MK, Jani BD, McConnachie A, Hanlon P, McLoone P, Nicholl BI, Carrero JJ, Nitsch D, McAllister D, Mair FS, Mark PB. Hospitalisation events in people with chronic kidney disease as a component of multimorbidity: parallel cohort studies in research and routine care settings. BMC Med. 2021 Nov 19. doi: 10.1186/s12916-021-02147-6. PMID: 34794437.


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