Nuffield Department of Primary Care Health Science, University of Oxford, Radcliffe Observatory Quarter, Oxford, United Kingdom.
National Institute for Health Research (NIHR), Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
PLoS One. 2021 Jan 15;16(1):e0245131. doi: 10.1371/journal.pone.0245131. eCollection 2021.
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.
Prospective cohort study in UK primary care.
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.
Participants underwent medical history and clinical assessment, and blood and urine sampling.
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.
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.
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.
确定 1-5 期慢性肾脏病（CKD）和短暂性肾功能受损患者的共病患病率，并确定与共病相关的因素。
英国初级保健中前瞻性队列研究。
861 名年龄在 60 岁及以上、肾功能下降的患者，其中 584 名（65.8%）患有 CKD，277 名（32.2%）未患有 CKD。
参与者接受了病史和临床评估以及血液和尿液采样。
共病定义为存在≥2 种慢性疾病，包括 CKD。描述了每种疾病、共存疾病和共病的患病率，并使用逻辑回归确定了共病的预测因素。
参与者的平均（±SD）年龄为 74±7 岁，54%为女性，98%为白人。在 CKD 之后，下一个最常见的疾病是高血压（n = 511，59.3%），其次是肥胖（n = 265，30.8%）、缺血性心脏病（n = 145，16.8%）和糖尿病（n = 133，15.4%）。同时存在两种共存疾病最为常见（27%），最常见的组合是高血压和肥胖（29%）。一种或三种疾病是下一个最常见的组合（分别为 20%和 21%）。所有参与者的共病患病率为 73.9%（95%CI 70.9-76.8），任何阶段 CKD 患者的患病率为 86.6%（95%CI 83.9-89.3）。逻辑回归发现，年龄增加（OR 1.07，95%CI 1.04-0.10）、BMI 增加（OR 1.15，95%CI 1.10-1.20）和 eGFR 降低（OR 0.99，95%CI 0.98-1.00）与共病显著相关。
这是第一项在所有阶段筛查出的患有或有风险的 CKD 的老年初级保健人群中，对共病患病率进行准确估计的分析。高血压和肥胖是除 CKD 以外最常见的共存疾病组合，这表明在 CKD 患者中密切监测健康状况可能有多种原因。
