Adherence to life's essential 8 and incident chronic kidney disease: a prospective study of 147, 988 UK Biobank participants

Tang, Rui, Tulane University

Background: The American Health Association (AHA) recently released Life’s essential 8 (LE8) score. We aimed to investigate the association between levels of cardiovascular health (CVH) and the risk of chronic kidney disease (CKD) in the UK biobank.

Methods: A total of 147,988 participants free of CKD and cardiovascular disease (CVD) from the UK biobank were included in this prospective study. CVH levels were categorized as low (0-49), moderate (50-79), and high (80-100) using LE8 score. An adjusted Cox proportional hazard model was used to investigate the association between LE8 and CKD. The population attributable risk (PAR) was also calculated.

Results: During a median follow-up of 10 years, 1,936 CKD cases were documented. A higher LE8 score was associated with a significant lower risk of CKD (P<0.001) and a linear dose–response relationship was observed. Similar patterns were also found in the associations of the LE8 behavior and biological subscale scores with CKD. Compared to participants with a low CVH category, participants with a moderate CVH were associated with a 35% lower risk of developing CKD (HR=0.65, 95% CI: 0.59, 0.73); and those with a high CVH had a 48% lower risk of CKD incidence (HR=0.52, 95% CI: 0.45, 0.60) after adjustment for covariates. Among 8 distinct metrics of LE8 score, BMI metric had the highest PAR (15.7%, 95% CI: 11.4-19.9). And 3.0% (95% CI: 1.2, 4.8) of the total CKD risk was attributable to non-adhering to a proper sleep duration.

Conclusion: High CVH, defined by LE8, was significantly associated with a lower risk of CKD. These results suggest that promoting optimal cardiovascular health may lower the burden of CKD.