The impact of multiple long-term conditions on mortality, progression to kidney failure and health-related quality of life among people with chronic kidney disease: a multicentre cohort study (NURTuRE-CKD)

作者：Boateng I, Phillips T, Harris S, Aiyegbusi OL, Cockwell P, Kalra PA, McDonnell T, Lucas B, Roderick PJ, Wheeler DC, Taal MW, Fraser SDS · 发表于：Annals of medicine · 年份：2026 · DOI：10.1080/07853890.2026.2692812 · 被引用次数：51 · 研究领域：Quality of Life、Renal Insufficiency, Chronic、Kidney Failure, Chronic、Humans、Female、Male、Disease Progression、Aged、Middle Aged、Prospective Studies、Comorbidity、United Kingdom

BACKGROUND: Multiple long-term conditions (MLTC) are common in people with chronic kidney disease (CKD). This study examined the impact of MLTC on mortality, CKD progression, and health-related quality of life (HRQoL) in a referred CKD population. METHODS: Adults with non-kidney replacement therapy (KRT)-dependent CKD (stages G1 to G5) were recruited to the prospective NURTuRE-CKD cohort across 16 UK nephrology centres. MLTC was defined as ≥2 conditions (including CKD) and comorbidities categorised into 19 groups. Depression and anxiety were defined using the Hospital Anxiety and Depression Scale, and Cognitive impairment using the Six-item Cognitive Impairment Test. Outcomes were all-cause mortality, CKD progression (eGFR <15 mL/min/1.73m2 or KRT), and HRQoL (EQ-5D-5L, at two time points). Participants with eGFR < 15 at baseline were excluded from progression analyses. RESULTS: All 2996 participants had comorbidities at baseline, and therefore MLTC. Mean age was 62.7 (SD ± 14.7) years, mean eGFR 37.3 mL/min/1.73m2 (SD ± 17.9), and 41% were female. Median baseline comorbidity count was 3 (IQR 2 to 5; range 1 to 19). The commonest baseline comorbidities were hypertension, pain, obesity, hyperuricaemia, diabetes, sarcopenia, and cardiovascular disease. Over a median 1.42 years between baseline and first follow up, the most frequent new comorbidities were pain (285 people (14%)), anxiety and depression (226 (11%)), cognitive impairment (115 (6%)), obesity (98 (5%)), and anaemi...