Evidence map›Paper›PMID 36209732›Full record

ArticleAmerican journal of nephrology2022

Age-Related Association between Multimorbidity and Mortality in US Veterans with Incident Chronic Kidney Disease.

Nilka Ríos Burrows, Alain K Koyama, Devasmita Choudhury, Wei Yu, Meda E Pavkov, Robert Nee, Alfred K Cheung, Keith C Norris, Guofen Yan

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of nephrology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.4field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 10 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 1 country.

Nilka Ríos BurrowsDivision of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Alain K KoyamaDivision of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Devasmita ChoudhuryVA Salem Medical Center, Salem, Virginia, USA.
Wei YuDepartment of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia, USA.
Meda E PavkovDivision of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Robert NeeNephrology Service, Walter Reed National Military Medical Center, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA.
Alfred K CheungVeterans Affairs Salt Lake City Healthcare System, Salt Lake City, Utah, USA.
Keith C NorrisDepartment of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA.
Guofen YanDepartment of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia, USA.
Centers for Disease Control and Prevention · USUniversity of Virginia · USSalem VA Medical Center · USUniversity of California, Los Angeles · USUniversity of Utah · USWalter Reed National Military Medical Center · US

Funding

UCLA Clinical Translational Science InstituteUL1TR001881 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI ARLEEN F. BROWN, ARASH NAEIM · 2016 to 2026
$118.1M
UCLA Clinical and Translational Science InstituteUL1TR000124 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI DUBINETT, STEVEN M. · 2012 to 2015
$57.0M
The Center for Health Improvement of Minority ElderlyP30AG021684 · NIA · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Homero Erwin del Pino · 2002 to 2026
$19.7M
UCLA-UCI Center for Eliminating Cardio-Metabolic Disparities in Multi-Ethnic Populations (UC END-DISPARITIES)P50MD017366 · NIMHD · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI BODEN-ALBALA, BERNADETTE MARIE, BROWN, ARLEEN F. · 2021 to 2025
$17.3M
Racial and ethnic disparities in kidney outcomes among people at risk for chronic kidney disease (CKD)R01DK112008 · NIDDK · UNIVERSITY OF VIRGINIA · PI Julia J Scialla, Guofen Yan · 2018 to 2026
$2.2M
Intramural CDC HHS CC999999NCATS NIH HHS UL1 TR000124NCATS NIH HHS UL1 TR001881NIA NIH HHS P30 AG021684NIDDK NIH HHS R01 DK112008NIMHD NIH HHS P50 MD017366
6 · The paper itself

Abstract

introductionMortality is an important long-term indicator of the public health impact of chronic kidney disease (CKD). We investigated the role of individual comorbidities and multimorbidity on age-specific mortality risk among US veterans with new-onset CKD.

methodsThe cohort included 892,005 veterans aged ≥18 years with incident CKD stage 3 between January 2004 and April 2018 in the US Veterans Health Administration (VHA) system and followed until death, December 2018, or up to 10 years. Incident CKD was defined as the first-time estimated glomerular filtration rate (eGFR) was <60 mL/min/1.73 m2 for >3 months. Comorbidities were ascertained using inpatient and outpatient clinical records in the VHA system and Medicare claims. We estimated death rates for any cardiovascular disease (CVD, a composite of 6 CVD conditions) and 15 non-CVD comorbidities, and adjusted risks of death (hazard ratio [HR], 95% confidence interval [CI]) overall and by age group at CKD incidence.

resultsAt CKD incidence, the mean age was 72 years, and 97% were male; the mean eGFR was 52 mL/min/1.73 m2, and 95% had ≥2 comorbidities (median, 4) in addition to CKD. During a median follow-up of 4.5 years, among the 16 comorbidities, CVD was associated with the highest relative risk of death in younger veterans (HR 1.96 [95% CI: 1.61-2.37] in ages 18-44 years and HR 1.66 [1.63-1.70] in ages 45-64 years). Dementia was associated with the highest relative risk of death among older veterans (HR 1.71 [1.68-1.74] in ages 65-84 years and HR 1.69 [1.65-1.73] in ages 85-100 years). The additive effect of multimorbidity on risk of death was stronger in younger than older veterans. Compared to having 1 or no comorbidity at CKD onset, the risk of death with ≥5 comorbidities was >7-fold higher among veterans aged 18-44 years and >2-fold higher among veterans aged 85-100 years.

conclusionThe large burden of comorbidities in US veterans with newly identified CKD places them at the risk of premature death. Compared with older veterans, younger veterans with multiple comorbidities, particularly with CVD, at CKD onset are at an even higher relative risk of death.

Indexed as

Cardiovascular DiseasesRenal Insufficiency, ChronicVeteransAdolescentAdultAgedFemaleGlomerular Filtration RateHumansMaleMedicareMultimorbidityRisk FactorsUnited StatesCardiovascular diseaseChronic kidney diseaseDementiaMortalityMortality risk

Identifiers

PMID36209732
PMCPMC10880036
OpenAlexW4303470821

What Socratic holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.