慢性肾脏病（CKD）的当前患病率很高，CKD患者面临着较高的死亡风险，包括全因死亡和特定原因的死亡结果。本研究旨在探究遵守至关重要的八个要素（LE8）对降低CKD患者死亡率的潜在影响。利用2005年至2018年的美国国家健康和营养调查数据（NHANES），我们对22,420名美国成年人（≥20岁）进行了分析。CKD的定义为尿白蛋白/肌酐比值（≥30 mg/g或3 mg/mmol）及估计的肾小球滤过率（<60 ml/min/1.73m2）。LE8的要素包括饮食、体育活动（PA）、尼古丁暴露、睡眠、身体质量指数、血脂、血糖和血压（BP），并给予0-100分。总的LE8分数是所有要素的未加权平均值，并分为低心血管健康（CVH）（0-49分）、中等CVH（50-79分）和高CVH（80-100分）。使用Cox比例风险回归模型研究了LE8与全因死亡率、心血管疾病（CVD）死亡率和癌症死亡率的相关性，这些结果由国家卫生统计中心追踪至2019年12月31日。在整体人群中，中等CVH的个体患CKD的风险降低了47%，而高CVH与低CVH相比，风险降低了55%。在中位随访7.58年的过程中，CKD患者的全因死亡率提高了93%，CVD死亡率提高了149%，与无CKD的人群相比。在CKD患者中，LE8分数每增加10分，与全因死亡风险减少了17%有关（特别是与PA、尼古丁暴露、血糖和BP有关），与CVD死亡风险减少了18%有关（特别是与PA有关），与癌症死亡风险减少了12%有关（特别是与PA和睡眠健康有关）。在附加和敏感性分析中，考虑了肾功能的潜在混杂因素后，结果仍然显著。此外，LE8在CKD患者中显示出比LS7更好的心血管疾病死亡风险分层。LE8与年龄、教育水平、婚姻状况和饮酒状况之间存在相互作用。本研究表明，CKD患者遵循更高LE8水平与全因和特定死亡风险降低相关。S. Karger AG, Basel.

The current prevalence of chronic kidney disease (CKD) is substantial, and CKD individuals face a heightened risk of mortality, encompassing both all-cause and cause-specific outcomes. The current study aims to investigate the potential impact of adhering to Life Essential 8 (LE8) on reducing mortality among CKD individuals.Using the National Health and Nutrition Survey (NHANES) data from 2005 to 2018, we analyzed 22,420 United States adults (≥20 years old). CKD is defined by urinary albumin-to-creatinine ratio (≥30 mg/g or 3 mg/mmol) and estimated glomerular filtration rate (<60 ml/min/1.73m2). The components of LE8, including diet, physical activity (PA), nicotine exposure, sleep, Body Mass Index, blood lipids, blood glucose, and blood pressure (BP) were measured and given a score of 0-100. The total LE8 score was the unweighted average of all components and was divided into low cardiovascular health (CVH) (0-49), moderate CVH (50-79), and high CVH (80-100). Cox proportional hazards regression model was used to explore the associations of LE8 with all-cause, cardiovascular disease (CVD), and cancer mortality, which were followed prospectively by the National Center for Health Statistics until December 31, 2019.In the overall population, individuals with moderate CVH had a 47% lower risk of CKD, while high CVH was linked to a 55% lower risk compared to low CVH. During a median follow-up of 7.58 years, CKD individuals had a 93% higher all-cause mortality rate and a 149% higher CVD mortality rate compared to those without CKD. Among the CKD individuals, every 10-point increase in LE8 score was associated with reduced risks of 17% for all-cause mortality (especially PA, nicotine exposure, blood glucose, and BP), 18% for CVD mortality (especially PA), and 12% for cancer mortality (especially PA and sleep health). In additional and sensitivity analysis, the results remained significant after further consideration of potential confounding of renal function. Additionally, LE8 demonstrated superior risk stratification for CVD mortality among CKD patients compared with LS7. Interaction was observed between LE8 and age, education level, marital status, and drinking status.The current study demonstrates that adherence to higher LE8 levels within CKD individuals is associated with a reduced risk of both all-cause and cause-specific mortality.S. Karger AG, Basel.