Association of social isolation and loneliness with the incidence and life expectancy of chronic kidney disease: a population-based cohort study.

BACKGROUND

Mental health has gained unprecedented attention in recent years, with social isolation and loneliness increasingly recognized as risk factors for cardiometabolic diseases and premature mortality. However, the relationship between these psychosocial factors and the incidence and mortality of chronic kidney disease (CKD) remains inadequately explored.

METHODS

We utilized data from the UK Biobank cohort, categorizing participants based on their questionnaire responses into groups reflecting the degree of social isolation (least isolated, moderately isolated, most isolated) and presence or absence of loneliness. Cox proportional hazards models were utilized to evaluate the relationships between social isolation, loneliness, and the incidence and mortality rates of CKD. Additionally, life tables were applied to estimate life expectancy.

RESULTS

We included 406 332 individuals without CKD and 60 331 CKD patients. During a median follow-up of 13.5 years, we documented 24 984 incident cases of CKD. Social isolation (HR 1.21, 95% CI: 1.17-1.26) and loneliness (HR 1.26, 95% CI: 1.21-1.33) were both significantly associated with increased CKD risk. Significant interactions were observed between social isolation and genetic risk ( P for interaction = 0.008), but no such interaction was found for loneliness ( P for interaction = 0.383). Among CKD patients, those in the most isolated and loneliness groups demonstrated a 33% and 10% higher risk of mortality, respectively. Moreover, life expectancy was notably reduced in the most isolated group (by 2.04 years in females and 2.98 years in males) and in the loneliness group (by 0.58 years in females and 1.03 years in males).

CONCLUSIONS

Social isolation and loneliness were independently associated with an elevated risk of both the incidence and mortality of CKD. These findings highlight the need to integrate strategies targeting social isolation and loneliness into CKD prevention and management.