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      Associations Between Life's Essential 8 and Chronic Kidney Disease

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          Abstract

          Background

          Chronic kidney disease (CKD) is closely associated with cardiovascular disease. We aimed to examine the association of Life's Essential 8 (LE8), the recently updated measurement of cardiovascular health, with the prevalence of CKD among US adults.

          Methods and Results

          This population‐based cross‐sectional study used data from the National Health and Nutrition Examination Survey from 2007 to 2018 and included adults aged ≥20 years. Multivariable logistic and restricted cubic spline models were used to assess the associations between LE8 and CKD. Among 24 960 participants, 4437 were determined to have CKD (weighted percentage, 14.11%). After the adjustment of potential confounders, higher LE8 scores were associated with reduced odds of CKD (odds ratio for each 10‐point increase, 0.79 [95% CI, 0.76–0.83]), and a nonlinear dose–response relationship was observed. Similar patterns were also identified in the associations of health behavior and health factor scores with CKD. Meanwhile, higher scores for blood glucose (odds ratio, for each 10‐point increase, 0.88 [95% CI, 0.87–0.90]) and blood pressure (odds ratio, for each 10‐point increase, 0.92 [95% CI, 0.91–0.94]) in the LE8 component are significantly associated with a lower prevalence of CKD. The inversed association of LE8 score and CKD was significantly stronger among middle‐aged, male, and coupled participants.

          Conclusions

          LE8 was negatively associated with the prevalence of CKD in a nonlinear fashion. Promoting adherence to optimal cardiovascular health levels may be beneficial to reduce the burden of CKD.

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          Most cited references47

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          A new equation to estimate glomerular filtration rate.

          Equations to estimate glomerular filtration rate (GFR) are routinely used to assess kidney function. Current equations have limited precision and systematically underestimate measured GFR at higher values. To develop a new estimating equation for GFR: the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Cross-sectional analysis with separate pooled data sets for equation development and validation and a representative sample of the U.S. population for prevalence estimates. Research studies and clinical populations ("studies") with measured GFR and NHANES (National Health and Nutrition Examination Survey), 1999 to 2006. 8254 participants in 10 studies (equation development data set) and 3896 participants in 16 studies (validation data set). Prevalence estimates were based on 16,032 participants in NHANES. GFR, measured as the clearance of exogenous filtration markers (iothalamate in the development data set; iothalamate and other markers in the validation data set), and linear regression to estimate the logarithm of measured GFR from standardized creatinine levels, sex, race, and age. In the validation data set, the CKD-EPI equation performed better than the Modification of Diet in Renal Disease Study equation, especially at higher GFR (P < 0.001 for all subsequent comparisons), with less bias (median difference between measured and estimated GFR, 2.5 vs. 5.5 mL/min per 1.73 m(2)), improved precision (interquartile range [IQR] of the differences, 16.6 vs. 18.3 mL/min per 1.73 m(2)), and greater accuracy (percentage of estimated GFR within 30% of measured GFR, 84.1% vs. 80.6%). In NHANES, the median estimated GFR was 94.5 mL/min per 1.73 m(2) (IQR, 79.7 to 108.1) vs. 85.0 (IQR, 72.9 to 98.5) mL/min per 1.73 m(2), and the prevalence of chronic kidney disease was 11.5% (95% CI, 10.6% to 12.4%) versus 13.1% (CI, 12.1% to 14.0%). The sample contained a limited number of elderly people and racial and ethnic minorities with measured GFR. The CKD-EPI creatinine equation is more accurate than the Modification of Diet in Renal Disease Study equation and could replace it for routine clinical use. National Institute of Diabetes and Digestive and Kidney Diseases.
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            The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.

            Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September, 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles.18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies.A detailed explanation and elaboration document is published separately and is freely available on the websites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE statement will contribute to improving the quality of reporting of observational studies
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              Heart Disease and Stroke Statistics—2020 Update

              Circulation
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                Author and article information

                Contributors
                liuzaoqu@163.com
                fcchanxw@zzu.edu.cn
                Journal
                J Am Heart Assoc
                J Am Heart Assoc
                10.1002/(ISSN)2047-9980
                JAH3
                ahaoa
                Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
                John Wiley and Sons Inc. (Hoboken )
                2047-9980
                08 December 2023
                19 December 2023
                : 12
                : 24 ( doiID: 10.1002/jah3.v12.24 )
                : e030564
                Affiliations
                [ 1 ] Department of Interventional Radiology The First Affiliated Hospital of Zhengzhou University Zhengzhou Henan China
                [ 2 ] Department of Respiratory and Critical Care Medicine The First Affiliated Hospital of Zhengzhou University Zhengzhou Henan China
                [ 3 ] Department of Vascular Surgery The First Affiliated Hospital of Zhengzhou University Zhengzhou Henan China
                [ 4 ] Department of Endovascular Surgery The First Affiliated Hospital of Zhengzhou University Zhengzhou Henan China
                [ 5 ] Interventional Institute of Zhengzhou University Zhengzhou Henan China
                [ 6 ] Interventional Treatment and Clinical Research Center of Henan Province Zhengzhou Henan China
                [ 7 ] Department of Hepatobiliary and Pancreatic Surgery The First Affiliated Hospital of Zhengzhou University Zhengzhou Henan China
                [ 8 ] Department of Clinical Medicine Zhengzhou University Zhengzhou Henan China
                Author notes
                [*] [* ] Correspondence to: Xinwei Han and Zaoqu Liu, Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. Email: fcchanxw@ 123456zzu.edu.cn ; liuzaoqu@ 123456163.com

                Author information
                https://orcid.org/0009-0000-2350-500X
                https://orcid.org/0000-0002-0972-4537
                https://orcid.org/0000-0002-3473-2248
                https://orcid.org/0000-0003-3745-9459
                https://orcid.org/0000-0003-1756-0082
                https://orcid.org/0000-0002-0452-742X
                https://orcid.org/0000-0003-4407-4864
                Article
                JAH39094 JAHA/2023/030564
                10.1161/JAHA.123.030564
                10863789
                38063194
                ab7bb546-7de1-4571-9035-f900b4a8bbc7
                © 2023 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 12 April 2023
                : 14 November 2023
                Page count
                Figures: 3, Tables: 4, Pages: 11, Words: 5930
                Categories
                Original Research
                Original Research
                Kidney in Cardiovascular Disease
                Custom metadata
                2.0
                19 December 2023
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.3.6 mode:remove_FC converted:19.12.2023

                Cardiovascular Medicine
                cardiovascular health,chronic kidney disease,life's essential 8,nhanes,lifestyle

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