Cardiovascular health by Life's Essential 8 and chronic kidney disease: Korea National Health and Nutrition Examination Survey 2019-2021.

BACKGROUND

Evidence remains limited regarding the association between cardiovascular health (CVH), as defined by Life's Essential 8 (LE8), and chronic kidney disease (CKD), particularly across its indicators and stages.

METHODS

We analyzed data from 12,264 adults in the Korea National Health and Nutrition Examination Survey (2019-2021). LE8 scores (range, 0-100), calculated from eight components-diet, physical activity, nicotine exposure, sleep, body mass index, blood lipids, blood glucose, and blood pressure, were analyzed as both continuous and categorical variables: low (0 to <50), moderate (50 to <80), and high CVH (80 to 100). CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 or albuminuria (urine albumin-to-creatinine ratio ≥30 mg/g). Multivariable logistic regression and restricted cubic spline models were used to examine associations between LE8 scores and CKD, with stratification by CKD indicators and by G and A stages.

RESULTS

Overall, 13.3% of participants were classified as having low CVH, 75.4% as moderate CVH, and 11.3% as high CVH. Compared to low CVH, the odds of CKD were lower in moderate CVH (odds ratio [OR], 0.39; 95% confidence interval [CI], 0.33-0.46) and high CVH (OR, 0.22; 95% CI, 0.15-0.33). Each 10-point higher CVH score was associated with 33% lower odds of CKD (OR, 0.67; 95% CI, 0.63-0.71). After stratifying decreased eGFR and albuminuria by G and A stages, higher CVH was consistently associated with lower odds of CKD, even for early stages.

CONCLUSION

Higher LE8 scores were inversely associated with CKD and its indicators, including early-stage CKD.