Pain and Kidney Disease Risk in Older Adults: CHARLS Longitudinal Study

Kidney disease is a global public health concern, with prevalence increasing among older adults. Early identification of high-risk older adult populations is crucial for timely intervention and treatment. This study utilized data from the China Health and Retirement Longitudinal Study to systematically assess the association between multi-site pain and kidney disease in older adults.

A national prospective longitudinal cohort study designed to investigate the association between baseline pain exposure and subsequent kidney disease outcomes.

A total of 13,062 participants from the 2011 baseline were followed across five waves until 2020. Baseline pain symptoms from Wave 1 were analyzed for their association with kidney disease occurrence, defined as diagnosis either at baseline or during follow-up. Pain symptoms included headache, back pain, chest pain, and abdominal pain. Based on multivariable regression analyses, a pain diagnostic score was constructed by assigning weights to different pain sites.

Results showed that headache, back pain, chest pain, and abdominal pain were consistently associated with kidney disease across multiple waves. The pain score was positively correlated with kidney disease prevalence (area under the curve = 0.637), and higher scores corresponded to progressively increased risk, up to 3.7 times the overall prevalence, indicating its potential diagnostic value in early screening.

This study proposes a simple, pain-based score as a potential risk-alert tool for kidney disease in older adults, suggesting its utility in prompting further clinical evaluation. The pain diagnostic score provides a potentially simple and effective tool for early screening of high-risk individuals, supporting timely intervention and possibly slowing disease progression.

This pain-based risk score provides a low-cost, easily implementable screening tool for kidney disease in older adults, particularly suitable for primary care and resource-limited settings. It enables rapid risk stratification to prioritize targeted renal function testing, and also reminds clinicians to screen for underlying renal impairment before prescribing nephrotoxic analgesics such as NSAIDs to elderly patients with chronic pain.