Acute and chronic complication profiles among patients with chronic kidney disease in Alberta, Canada: a retrospective observational study
Date
2024-07-29
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Abstract
Abstract
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.
Three Key Points • CKD poses a substantial burden to individuals, caregivers, and healthcare systems with respect to adverse events and conditions that occur with or following CKD. • This study provides an overview of comorbidities/complications observed in patients with CKD in a Canadian real-world clinical setting. This report is more detailed than currently available published literature, examining a comprehensive list of cardiovascular, diabetic, renal, fracture, and infectious outcomes. • CKD affects a substantial proportion of the adult population in Alberta, with high rates of complications experienced by patients with CKD, particularly among those with cardio-renal-metabolic comorbidities. Clinical implications: Results from this study provide estimates to inform the healthcare resources needed to provide optimal care for patients living with CKD, including early detection and management of complications.
Three Key Points • CKD poses a substantial burden to individuals, caregivers, and healthcare systems with respect to adverse events and conditions that occur with or following CKD. • This study provides an overview of comorbidities/complications observed in patients with CKD in a Canadian real-world clinical setting. This report is more detailed than currently available published literature, examining a comprehensive list of cardiovascular, diabetic, renal, fracture, and infectious outcomes. • CKD affects a substantial proportion of the adult population in Alberta, with high rates of complications experienced by patients with CKD, particularly among those with cardio-renal-metabolic comorbidities. Clinical implications: Results from this study provide estimates to inform the healthcare resources needed to provide optimal care for patients living with CKD, including early detection and management of complications.
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Citation
BMC Nephrology. 2024 Jul 29;25(1):244