Kidney disease
How often does mild kidney disease come with other illnesses?
Open access · cc by · source: Europe PMC
Almost everyone with moderate chronic kidney disease in primary care had other chronic conditions, and having more of them was linked to a higher risk of dying.
Study at a glance
- Design
- Cohort — Prospective cohort (Renal Risk in Derby) recruited from 32 English general practices, with baseline comorbidity and medication counts and linked death records over a mean of 3.6 years.
- N
- N=1741 · 1741 people with CKD stage 3 recruited and analysed; 175 died during follow-up.
- Population
- Mostly older, white adults with chronic kidney disease stage 3 managed in English primary care
- Outcome
- Number of comorbidities (from a list of eleven) and medications at baseline; all-cause mortality during follow-up
Structured fields used in claim comparison tables when every cited study has a complete layer.
Key findings
Only 78 of 1741 participants (4%) had kidney disease with none of the listed comorbidities, while 40% had more than two. The median person took five medications, 59% took five or more and 11% took ten or more; heavier medication use went with more comorbidities, older age, smoking, higher BMI, lower kidney function and lower education. Over a mean follow-up of 3.6 years, 175 people (10%) died, most often from cardiovascular disease. Having three or more comorbidities was linked to roughly three times the risk of death compared with none or one after adjusting for sociodemographic factors (hazard ratio 3.15), and comorbidity count stayed an independent predictor in the fully adjusted model.
Methodology
The researchers recruited 1741 people with stage 3 chronic kidney disease from 32 general practices in Derbyshire, England. At a baseline visit they recorded eleven common comorbidities (such as hypertension, diabetes, heart disease, depression and chronic pain), counted each person's regular medications, and took blood and urine samples. They then followed participants through national death records and used Cox regression to relate the number of comorbidities to all-cause mortality, adjusting for age, sex, education, deprivation, smoking, BMI and kidney function.
Limitations
There was no comparison group without kidney disease, so the study cannot say how much of this multimorbidity is specific to CKD rather than to ageing. Several conditions (depression, respiratory disease, chronic pain, thyroid disorder) were defined only by medication use and others by self-report, so some were probably missed, and cancer, liver disease, frailty and disease severity were not captured. Participants were volunteers who could attend their GP surgery and were almost all white, so the sample may be healthier and less diverse than the wider CKD population. As an observational study it shows association with mortality, not that comorbidities themselves cause the deaths.
How this study connects
Role on claims
Each row is a claim on a concept or method page where this paper supports, challenges, or qualifies the statement. Roles are hand-checked — not a model guess.
Moderate CKD almost always comes with other illnesses, and the load predicts mortality.
In a primary-care cohort of 1,741 people with stage 3 CKD, only 4% had no other listed chronic condition, 59% took five or more medicines, and having three or more comorbidities was associated with about three times the risk of death over 3.6 years (HR 3.15).
Evidence for the claim as stated.
Moderate CKD almost always comes with other illnesses, and the load predicts mortality.
In a primary-care cohort of 1,741 people with stage 3 CKD, only 4% had no other listed chronic condition, 59% took five or more medicines, and having three or more comorbidities was associated with about three times the risk of death over 3.6 years (HR 3.15).
Scope note — No comparison group without CKD, mostly white volunteers; association, not causation.
Limits the claim's scope: a different population, assay, or outcome.
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