Lower Life’s Essential 8 Scores Associated With Higher End-Stage Kidney Disease Risk

A prospective analysis in the Clinical Journal of the American Society of Nephrology examined whether Life’s Essential 8 (LE8), a cardiovascular health metric combining eight behavioral and biological factors, was associated with end-stage kidney disease (ESKD). Researchers included 276,494 UK Biobank participants without ESKD at baseline. Scores were categorized as low (0–49), moderate (50–79), or high (80–100). The outcome was incident ESKD, defined as requiring kidney replacement therapy or reaching CKD stage G5.

During a median 14.1-year follow-up, 455 participants developed ESKD. In fully adjusted models, each 10-point lower LE8 score was associated with a higher hazard of ESKD (HR 1.47; 95% CI 1.34–1.60). Compared with high scores, moderate scores were associated with an HR of 2.11 (95% CI 1.39–3.21), and low scores with an HR of 5.57 (95% CI 3.42–9.07). Risk gradients were steeper at lower scores. Blood pressure and blood glucose had the largest estimated population-attributable fractions among the components assessed.

The findings support further investigation of LE8-guided prevention strategies but do not establish that improving LE8 scores prevents ESKD. The observational design cannot establish causality, and the predominantly White cohort (95%), with a mean age of 56 years, may limit generalizability.