Social disconnection, psychometric pain risk prediction, and cardiovascular disease with life expectancy in patients with chronic kidney disease.

BACKGROUND

Understanding the impact of psychosocial factors and pain management on cardiovascular disease (CVD) risk and life expectancy in patients with chronic kidney disease (CKD) is critical for developing targeted interventions. We aimed to assess the associations of social isolation, loneliness, and pain risk with incident CVD in patients with CKD and to evaluate the impact of these factors on the life expectancy of CKD patients.

METHODS

This prospective cohort study comprised 34,381 CKD patients from the UK Biobank. Loneliness and social isolation were measured using two-item and three-item scales, respectively. The risk of pain spreading score (ROPS) was determined by summing responses to six items based on mood, trauma, sleep, neuroticism, and anthropometric measurement. The Cox proportional hazards regression model was used to evaluate CVD risk by estimating hazard ratios (HRs) and 95 % confidence intervals (CIs).

RESULTS

Higher levels of loneliness (HR2 vs. 0 = 1.32, 95 % CI = 1.22-1.44), social isolation (HR2+ vs. 0 = 1.11, 95 % CI = 1.04-1.19), and higher ROPS (HRhigh vs low risk = 1.34, 95 % CI = 1.28-1.40) were associated with a higher risk of CVD in CKD patients (P-trend<0.001 for all). Significant interactions between loneliness and ROPS were observed, suggesting a synergistic effect on CVD risk. Moreover, loneliness, social isolation, and elevated ROPS were significantly associated with reduced life expectancy among patients with CKD.

CONCLUSIONS AND RELEVANCE: The study findings suggest that addressing social isolation and loneliness, along with effective pain management, is crucial for reducing the risk of CVD and improving life expectancy in patients with CKD.