title: Multimorbidity in people with chronic kidney disease: implications for outcomes and treatment.
abstract: With ageing populations, the prevalence of multimorbidity is increasing. This review discusses recent developments in the understanding of multimorbidity in the context of chronic kidney disease (CKD). It explores the associated treatment burden and the implications for key outcomes and patient care.
  
  
  
  Comorbidity and polypharmacy are common in CKD, even at early stages, and are associated with significant treatment burden. Both 'concordant' and 'discordant' comorbidities have a negative impact on mortality, cardiovascular disease, hospitalisation and length of stay. In addition, quality of life is influenced by many factors beyond CKD, including comorbidities and certain medications. Several factors may reduce treatment burden for people with CKD, though research on this is at an early stage. Although patient activation is desirable to support self-management amongst people with multimorbidity, there are significant challenges that impact patient capacity amongst elderly populations with complex needs.
  
  
  
  Comorbidities are common in CKD and have important implications for patients, clinicians and health services.
authors.affiliation: aAcademic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, Hampshire SO16 6YD bDivision of Medical Sciences and Graduate-Entry Medicine, University of Nottingham cDepartment of Renal Medicine, Royal Derby Hospital, Derby, UK.
authors.forename: Simon D S
authors.initials: SD
authors.lastname: Fraser
authors.forename: Maarten W
authors.initials: MW
authors.lastname: Taal
mesh_terms: D006801:Humans; D000076322:Multimorbidity; D000071066:Patient Reported Outcome Measures; D019338:Polypharmacy; D011788:Quality of Life; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000628:therapy*; D012648:Self Care