Association of life’s essential 8 with prevalence and all-cause mortality of chronic kidney disease among US adults: Results from the National Health and Nutrition Examination Survey (2015–2018)

Abstract Background and Objectives The association between chronic kidney disease (CKD) and cardiovascular disease has been previously evaluated. This study aimed to evaluate the association between the American Heart Association’s Life’s Essential 8 (LE8) and the prevalence and all-cause mortality of CKD in a nationally representative population of adults in the US. Methods This retrospective analysis included participants from the National Health and Nutrition Examination Survey spanning 2015–2018. We used multivariable survey logistic regression model to calculate the adjusted odds ratios (AORs) of the LE8 score for the prevalence of CKD. Survey-weighted Cox proportional hazards models were used to calculate the adjusted hazards ratios (AHRs) of the LE8 score for the risk of all-cause mortality among participants with CKD. Results Of the 8907 included participants, 789 had stage 3 to 5 CKD, and 8118 were in the non-CKD group. The adjusted prevalence rate of CKD was 10.7% in the low LE8 score group, and lower in the moderate (7.9%) and high (7.7%) LE8 score groups. Compared with low LE8 scores, moderate LE8 score (adjusted odds ratio AOR 0.628, 95% confidence interval CI: 0.463 to 0.853, P = 0.004) and high LE8 scores (AOR 0.328, 95% CI: 0.142 to 0.759, P = 0.011) were associated with lower prevalence rates of CKD. A similar association was found for health factors scores. Additionally, an increase in the LE8 score was associated with a lower risk of all-cause mortality (adjusted hazard ratio AHR 0.702, 95% CI: 0.594 to 0.829, P < 0.001). Conclusion The results of this study suggest the association of higher LE8 and its subscale scores with a lower prevalence and all-cause mortality of CKD.