Abstract Background Chronic conditions often cluster together, forming distinct multimorbidity patterns. We aimed to explore how such patterns are associated with the risk of albuminuria. Methods We utilized the Stockholm Creatinine Measurements (SCREAM) project, comprising 675,570 adults undergoing outpatient albuminuria testing in Stockholm, Sweden. Disease patterns were derived in adults without albuminuria at baseline, stratified by age (18–64, 65–74, ≥ 75 years). Associations with incident albuminuria (albumin-creatinine ratio > 30 mg/g) and macroalbuminuria (> 300 mg/g) were examined using Cox and Fine-Gray competing risk models. Results We identified four multimorbidity patterns in younger participants (18–64), six in the 65–74 group, and seven among those aged ≥ 75. Across all age groups, most patterns—including cardiovascular, mental health, and eye patterns—were consistently associated with elevated albuminuria risk compared to those without multimorbidity. In the 65–74 stratum, the cardiovascular pattern had the highest risk compared to those without multimorbidity (HR 3.09: 95% CI: 2.85–3.34). Among those aged ≥ 75, almost all identified patterns showed higher risk, with those in the vascular pattern being at highest risk (HR: 2.41, 95% CI: 2.08–2.80). The dementia pattern showed no significant association. High-burden patterns in older participants with numerous chronic conditions (e.g., multisystem and cardiovascular patterns) were at increased risk, but this was attenuated after accounting for the competing risk of death. The 5- to 6-year cumulative incidence of albuminuria exceeded 10–14% in the highest-risk patterns, 5–9% higher than for those without multimorbidity. In interaction analyses, reduced estimated glomerular filtration rate amplified risk among younger individuals. Females generally had lower risk, except with mental health patterns in younger ages or cardiovascular multimorbidity in those 65 to 74. Conclusions Multimorbidity patterns, including those characterized by non-traditional CKD risk factors, can help identify individuals at elevated albuminuria risk. Targeted screening of these groups may enable preventive strategies to slow or prevent kidney damage.
Beridze et al. (Tue,) studied this question.