TY - JOUR T1 - Chronic kidney disease and cause-specific hospitalisation: a matched cohort study using primary and secondary care patient data JF - British Journal of General Practice JO - Br J Gen Pract DO - 10.3399/bjgp18X697973 SP - bjgp18X697973 AU - Masao Iwagami AU - Ben Caplin AU - Liam Smeeth AU - Laurie A Tomlinson AU - Dorothea Nitsch Y1 - 2018/07/17 UR - http://bjgp.org/content/early/2018/07/16/bjgp18X697973.abstract N2 - Background Although chronic kidney disease (CKD) is associated with various outcomes, the burden of each condition for hospital admission is unknown.Aim To quantify the association between CKD and cause-specific hospitalisation.Design and setting A matched cohort study in primary care using Clinical Practice Research Datalink linked to Hospital Episode Statistics in England.Method Patients with CKD (estimated glomerular filtration rate <60 mL/min/1.73 m2 for ≥3 months) and a comparison group of patients without known CKD (matched for age, sex, GP, and calendar time) were identified, 2004–2014. Outcomes were hospitalisations with 10 common conditions as the primary admission diagnosis: heart failure; urinary tract infection; pneumonia; acute kidney injury (AKI); myocardial infarction; cerebral infarction; gastrointestinal bleeding; hip fracture; venous thromboembolism; and intracranial bleeding. A difference in the incidence rate of first hospitalisation for each condition was estimated between matched patients with and without CKD. Multivariable Cox regression was used to estimate a relative risk for each outcome.Results In a cohort of 242 349 pairs of patients, with and without CKD, the rate difference was largest for heart failure at 6.6/1000 person-years (9.7/1000 versus 3.1/1000 person-years in patients with and without CKD, respectively), followed by urinary tract infection at 5.2, pneumonia at 4.4, and AKI at 4.1/1000 person-years. The relative risk was highest for AKI with a fully adjusted hazard ratio of 4.90, 95% confidence interval (CI) = 4.47 to 5.38, followed by heart failure with 1.66, 95% CI = 1.59 to 1.75.Conclusion Hospitalisations for heart failure, infection, and AKI showed strong associations with CKD in absolute and(or) relative terms, suggesting targets for improved preventive care. ER -