Multiple Risk Factors Controlled and Mortality Risks in Chronic Kidney Disease

Area of Science:

• Nephrology
• Public Health
• Epidemiology

Background:

• Chronic kidney disease (CKD) is a significant contributor to elevated mortality rates.
• Investigating the impact of controlled risk factors on CKD-associated mortality is crucial for public health.

Purpose of the Study:

• To determine the extent to which controlling multiple modifiable risk factors can reduce excess mortality in CKD patients.
• To compare mortality risks between CKD patients with varying levels of risk factor control and non-CKD individuals.

Main Methods:

• Analysis of 2,394 CKD patients and 15,962 non-CKD individuals from NHANES (2007-2018).
• Assessment of seven modifiable risk factors: blood pressure, BMI, HbA1c, non-HDL cholesterol, smoking, physical activity, and diet.
• Utilized Cox models to evaluate associations between risk factor control and mortality outcomes.

Main Results:

• Each additional controlled risk factor in CKD patients was linked to a 19% reduction in all-cause mortality.
• Optimal control (6-7 factors) reduced all-cause mortality by 59% (HR: 0.41).
• CKD patients with 6-7 controlled factors exhibited no significant difference in all-cause, cardiovascular, or cancer mortality compared to non-CKD individuals.

Conclusions:

• Controlling multiple risk factors substantially reduces CKD-related excess mortality.
• Achieving optimal control of 6-7 risk factors can normalize mortality risks to levels comparable to non-CKD individuals.
• Integrated management strategies targeting biological and lifestyle factors are essential for the CKD population.