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Acute and chronic complication profiles among patients with chronic kidney disease in Alberta, Canada: a
David C W Lau1, Eileen Shaw2, Suzanne McMullen3
1Division of Endocrinology and Metabolism, Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, AB, Canada.
Insights
Over two-thirds of patients with chronic kidney disease (CKD) experienced complications, particularly those with cardio-renal-metabolic conditions. Early risk mitigation strategies are crucial for reducing patient burden.
Area of Science:
- Nephrology
- Public Health
- Epidemiology
Background:
- Chronic kidney disease (CKD) significantly impacts individuals, caregivers, and healthcare systems.
- CKD increases the risk of severe outcomes like renal failure, cardiovascular disease, and mortality.
- Understanding comorbidities and complications in CKD patients is vital for effective management.
Purpose of the Study:
- To describe the prevalence of comorbidities in CKD patients.
- To identify and quantify the incidence of acute and chronic complications in CKD patients.
- To analyze complication rates based on CKD stage and the presence of atherosclerotic cardiovascular disease (ASCVD) and type 2 diabetes mellitus (T2DM).
Main Methods:
- Retrospective observational study using administrative health databases in Alberta, Canada (2010-2019).
- Identified adult CKD patients based on diagnostic codes or lab tests.
- Analyzed comorbidities in the two years pre-index and complications post-index, stratified by CKD stage, ASCVD, and T2DM status.
Main Results:
- The study included 588,170 CKD patients.
- Common comorbidities included hypertension (36.9%) and T2DM (24.1%).
- High rates of acute complications like infection (58.2%) and cardiovascular hospitalization (24.4%) were observed. Chronic complications included dyslipidemia (17.3%) and anemia (14.7%).
- Patients with advanced CKD, ASCVD, or T2DM had higher complication rates.
Conclusions:
- More than two-thirds of CKD patients experienced complications.
- Complication rates were elevated in patients with co-existing cardio-renal-metabolic conditions.
- Implementing strategies to mitigate risk factors and complications is essential to lessen the burden on patients.
Background:
Chronic kidney disease (CKD) poses a substantial burden to individuals, caregivers, and healthcare systems. CKD is associated with higher risk for adverse events, including renal failure, cardiovascular disease, and death. This study aims to describe comorbidities and complications in patients with CKD.
Methods:
We conducted a retrospective observational study linking administrative health databases in Alberta, Canada. Adults with CKD were identified (April 1, 2010 and March 31, 2019) and indexed on the first diagnostic code or laboratory test date meeting the CKD algorithm criteria. Cardiovascular, renal, diabetic, and other comorbidities were described in the two years before index; complications were described for events after index date. Complications were stratified by CKD stage, atherosclerotic cardiovascular disease (ASCVD), and type 2 diabetes mellitus (T2DM) status at index.
Results:
The cohort included 588,170 patients. Common chronic comorbidities were hypertension (36.9%) and T2DM (24.1%), while 11.4% and 2.6% had ASCVD and chronic heart failure, respectively. Common acute complications were infection (58.2%) and cardiovascular hospitalization (24.4%), with rates (95% confidence interval [CI]) of 29.4 (29.3-29.5) and 8.37 (8.32-8.42) per 100 person-years, respectively. Common chronic complications were dyslipidemia (17.3%), anemia (14.7%), and hypertension (11.1%), with rates (95% CI) of 11.9 (11.7-12.1), 4.76 (4.69-4.83), and 13.0 (12.8-13.3) per 100 person-years, respectively. Patients with more advanced CKD, ASCVD, and T2DM at index exhibited higher complication rates.
Conclusions:
Over two-thirds of patients with CKD experienced complications, with higher rates observed in those with cardio-renal-metabolic comorbidities. Strategies to mitigate risk factors and complications can reduce patient burden.
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