College of Medical, Veterinary & Life Sciences

People with multiple health conditions – known as multimorbidity – are at risk of unplanned admissions to hospital. Now, new research has found the rates of hospitalisation in these people are even higher if one of their conditions is chronic kidney disease.

The new research, led by the University of Glasgow and published in BMC Medicine, examined the rates of hospitalisation in people with multimorbidity, including those who also have chronic kidney disease as one of those conditions.

The study found that while multimorbidity itself was associated with high rates of hospitalisation – those with four or more long term health conditions were almost five times more likely to be admitted to hospital than those without any health conditions – the rates of hospitalisation are two to three times higher when chronic kidney disease is one of the multimorbid conditions.

Overall, people with chronic kidney disease are more likely to have a greater number of long-term health conditions. Previous research has demonstrated how difficult it can be living with many conditions, such as needing to take multiple medications – known as polypharmacy – and this new study focuses on unplanned admissions to hospital.

Researchers suggest these findings reveal just how high-risk patients with chronic kidney disease are, and say that new research to better understand what might be causing this increased risk of hospitalisation is urgently needed so that patients can be better cared for and supported.

Dr Michael Sullivan, researcher at the University of Glasgow and lead author of the study, said: “Kidney disease is common (it affects 5 to 10% of the population) and we have demonstrated its importance in a person’s risk of being admitted to hospital. In the Covid era, we are all aware that people with health conditions are vulnerable to illnesses which lead to hospitalisation. Our research has shown that kidney disease is an incredibly important risk factor that must be recognised.”

Professor Patrick Mark, Professor of Nephrology at the University of Glasgow and senior author on the study, said: “For a long time nephrologists (kidney specialists) have suspected that people with kidney disease are at higher risk of hospitalisation, and now our research confirms this. The clinical team caring for these people should review them regularly, make sure they are on the right medications and pick up illnesses early, hopefully before admission to hospital is needed.”

Chronic kidney disease is a global health problem and is closely linked to adverse health outcomes. Compared to those without the condition, people with chronic kidney disease are more likely to be hospitalised, develop complications while in hospital, and also be re-admitted. These people have frequent contact with health care services, including clinic visits, blood tests, and in the small number of people with advanced disease, the need for dialysis and/or kidney transplantation. Unplanned hospitalisations are in addition to these many appointments, and are undesirable events which can cause heightened anxiety for patients, particularly when admissions are via emergency services.

Using data from a research study (the UK Biobank) and Welsh GP data (the Secure Anonymised Information Linkage Databank), the study found additional risk factors for hospitalisation: advanced kidney disease; being aged over 60; and having certain combinations of conditions including diabetes, heart disease and mental health conditions.

The study, ‘Hospitalisation events in people with chronic kidney disease as a component of multimorbidity’ is published in BMC Medicine. The work was funded by The Medical Research Council.

---

First published: 19 November 2021