AHA Life’s Essential 8 and new-onset CKD: a prospective cohort study from the UK Biobank

Dec 27, 2023Clinical and experimental nephrology

Heart health scores linked to new cases of chronic kidney disease in UK adults

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Abstract

Over a median follow-up of 12.8 years, 10,124 new cases of chronic kidney disease (CKD) were documented among 251,825 participants.

Higher Life's Essential 8 (LE8) scores are associated with a significant reduction in the risk of new-onset CKD.
Participants with high LE8 scores had a hazard ratio (HR) of 0.300 for developing CKD compared to those with low scores.
A median LE8 score resulted in an HR of 0.531 for CKD relative to low scores.
The association between LE8 scores and CKD risk was consistent across various subgroup analyses.
Genetic predisposition to CKD did not alter the observed relationships between LE8 scores and CKD incidence.

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BACKGROUND: The AHA has recently introduced a novel metric, Life's Essential 8, to assess cardiovascular health (CVH). Nevertheless, the association between varying levels of LE8 and the propensity for CKD is still unclear from a large prospective cohort. Our objective is to meticulously examine the relationship between LE8 and its associated susceptibilities to CKD.

METHODS: A total of 251,825 participants free of CKD from the UK Biobank were included. Cardiovascular health was scored using LE8 and categorized as low, moderate, and high. Cox proportional hazard models were employed to evaluate the associations of LE8 scores with new-onset CKD. The genetic risk score for CKD was calculated by a weighted method.

RESULTS: Over a median follow-up of 12.8 years, we meticulously documented 10,124 incident cases of CKD. Remarkably, an increased LE8 score correlated with a significant reduction of risk in new-onset CKD (high LE8 score vs. low LE8 score: HR = 0.300, 95% CI 0.270-0.330, p < 0.001; median LE8 score vs. low LE8 score: HR = 0.531, 95% CI 0.487-0.580, p < 0.001). This strong LE8-CKD association remained robust in extensive subgroup assessments and sensitivity analysis. Additionally, these noteworthy associations between LE8 scores and CKD remained unaffected by genetic predispositions to CKD.

CONCLUSIONS: An elevated degree of CVH, as delineated by the discerning metric LE8, exhibited a pronounced and statistically significant correlation with a marked reduction in the likelihood of CKD occurrence.

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AHA Life’s Essential 8 and new-onset CKD: a prospective cohort study from the UK Biobank

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