Relevance of Kidney-Metabolic Multimorbidity Pattern to Metabolic Health and Mortality Among Elderly Inpatients in China.

As populations age globally, multimorbidity has emerged as a significant challenge. Chronic kidney disease (CKD) is a common aging related condition whose contribution to mortality is rising, yet CKD associated multimorbidity are seldom reported. This study aims to investigate the prevalence and patterns of multimorbidity, with a specific focus on the CKD associated multimorbidity pattern and its impact on metabolic health and mortality. We conducted a cross-sectional analysis using a large dataset from Huashan hospital at Fudan University, Shanghai, China. Data were collected for patients aged over 60 years between January 1, 2013, and January 1, 2019. In total, 48 chronic diseases were included and multimorbidity was defined as the co-occurrence of two or more of these 48 diseases in a single patient. Our database included 163,626 elderly inpatients with a mean age of 69.82 ± 7.75 years. The number of morbidities was positively associated with mortality. 80.7% of patients with CKD had other comorbidities. Factor analysis revealed four multimorbidity patterns in the elderly inpatients, named as "Kidney-metabolic", "Cerebro-vascular", "Cardio-pulmonary" and "Thyroid-digestive" pattern. The "Kidney-metabolic" pattern, characterized by CKD, Hypertension, Diabetes, and Lipid disorders, exhibited the highest prevalence at 13.3%. All four multimorbidity patterns were significantly positively associated with increased mortality. However, the impact of the "Kidney-metabolic" pattern on mortality was the only one that significantly increased with age. Our results suggest that, "Kidney-metabolic" pattern, the most prevalent among the elderly, significantly highlighted intertwined nutrition and metabolic-related conditions and represented predominant combined risk factors for metabolic health.