Association of life’s essential 8 as a Cardiovascular Health Index with risk of chronic kidney disease; a systematic review and meta-analysis

Saeid Bejarzehi ¹ , Fatemeh Vahmani ² , Amir Heidari ³ , Fariba Jafari Khabaz ⁴ , Faeze Shafie Bafti ⁵ , Jalal Nourmohammadi ⁶ , Reyhaneh Sadeghian ⁴ , Reza Faramarzzadeh ⁷ , Mohammad Rostamzadeh ⁸^*

¹ Department of Nursing Medicine, Nursing and Midwifery School, Zahedan Islamic Azad University of Medical Sciences, Zahedan, Iran
² Department of Cardiology, Hazrat-e Rasool General Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
³ Department of Cardiology, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
⁴ Department of Nursing, Faculty of Nursing and Midwifery, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
⁵ Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
⁶ Student Research Committee, Department of Nursing, Faculty of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, Iran
⁷ Department of Cardiology, Seyed-Al-Shohada Cardiology Hospital, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
⁸ Department of Cardiology, Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

*Corresponding Author: Mohammad Rostamzadeh, Email: dr.m.rostamzade@gmail.com

Abstract

Introduction: Due to the close association between chronic kidney disease (CKD) and cardiovascular disease (CVD), maintaining optimal cardiovascular health (CVH) may serve as a preventive strategy to reduce the risk of CKD and its related health burden. Therefore, this study aimed to investigate the association between Life’s Essential 8 (LE8) and the risk of CKD.

Materials and Methods: This study systematically searched the Cochrane, Embase, PubMed, ProQuest, Web of Science, Scopus, and Google Scholar databases up to April 26, 2025. Data analysis was performed using IBM SPSS Statistics version 19 and STATA version 14.

Results: An increase in the LE8 score was associated with a reduced risk of CKD, as indicated by the odds ratio (OR: 0.74, 95% CI: 0.67–0.82) and hazard ratio (HR: 0.60, 95% CI: 0.46–0.77). The protective effect of higher LE8 scores was observed across various subgroups: individuals aged 40–49 (OR: 0.81, 95% CI: 0.78–0.84), 50–59 (OR: 0.75, 95% CI: 0.60–0.94), males (OR: 0.81, 95% CI: 0.76–0.87), females (OR: 0.91, 95% CI: 0.87–0.95), and populations from the UK (OR: 0.60, 95% CI: 0.46–0.77), China (OR: 0.64, 95% CI: 0.63–0.65), and the USA (OR: 0.77, 95% CI: 0.72–0.81). Similarly, both cohort studies (OR: 0.66, 95% CI: 0.54–0.81) and cross-sectional studies (OR: 0.73, 95% CI: 0.66–0.81) confirmed this inverse association. Moreover, compared to low LE8 scores, moderate (OR: 0.58, 95% CI: 0.52–0.65) and high (OR: 0.43, 95% CI: 0.35–0.53) LE8 scores were significantly associated with reduced CKD risk.

Conclusion: An increase in the LE8 score was associated with a greater reduction in the risk of CKD in older age groups compared to younger ones, and in men compared to women. Moreover, the higher the LE8 score, the lower the risk of developing CKD.

Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (ID: CRD420251043587) and Research Registry (UIN: reviewregistry2006) websites.

Keywords: Life’s essential 8, LE 8, Chronic kidney disease, Chronic renal insufficiency, Renal insufficiency, Chronic

Implication for health policy/practice/research/medical education:

The findings from the meta-analysis, revealed that both moderate and high levels of LE8 scores were significantly associated with reduced risk of chronic kidney disease (CKD) by 42% and 57%, respectively, compared to low LE8 scores. Subgroup analysis demonstrated that higher LE8 scores were associated with lower CKD risk in various populations: 19% reduction among individuals aged 40–49, 25% in those aged 50–59, 19% in men, and 9% in women.

Please cite this paper as: Bejarzehi S, Vahmani F, Heidari A, Jafari Khabaz F, Shafie Bafti F, Nourmohammadi J, Sadeghian R, Faramarzzadeh R, Rostamzadeh M. Association of life’s essential 8 as a Cardiovascular Health Index with risk of chronic kidney disease; a systematic review and meta-analysis. J Nephropathol. 2025;x(x):e27655. DOI: 10.34172/jnp.2025.27655.