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Open AccessArticle

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

Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
Author to whom correspondence should be addressed.
J. Clin. Med. 2018, 7(12), 493;
Received: 11 November 2018 / Revised: 23 November 2018 / Accepted: 26 November 2018 / Published: 28 November 2018
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. View Full-Text
Keywords: chronic kidney disease; multimorbidity; renal outcomes chronic kidney disease; multimorbidity; renal outcomes
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Lee, W.-C.; Lee, Y.-T.; Li, L.-C.; Ng, H.-Y.; Kuo, W.-H.; Lin, P.-T.; Liao, Y.-C.; Chiou, T. .-Y.; Lee, C.-T. The Number of Comorbidities Predicts Renal Outcomes in Patients with Stage 3–5 Chronic Kidney Disease. J. Clin. Med. 2018, 7, 493.

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