Combined healthy lifestyles, genetic susceptibility, and incident chronic kidney disease: A prospective cohort study

To investigate the associations of combined healthy lifestyles and genetic susceptibility with incident chronic kidney disease (CKD), and explored the potential gene-lifestyle interactions on CKD.

Cohort study.

We enrolled 23,436 participants from the Dongfeng-Tongji cohort, among whom 19,914 had available genotype data. A healthy lifestyle score was obtained by summing five low-risk lifestyle components, including never-smoking, 1-15 g/day of alcohol consumption, active exercise, 7-8 h of nighttime sleep, and 18.5-23.9 kg/m² of body mass index. A genetic risk score for CKD was determined with low (lowest quintile), intermediate (quintile 2-4), and high (highest quintile) groups. Modified Poisson regression model and logistic regression model were employed to evaluate the associations of healthy lifestyle score and genetic risk score with incident CKD.

Over a follow-up period of 175,784.83 person-years, we documented 3828 incident CKD events. Individuals scoring 4-5 on the healthy lifestyle score experienced a 31 % (22 %, 39 %) lower risk of incident CKD compared with those scoring 0-1. Approximately 27.50 % of CKD events could be attributed to insufficient adherence to healthy lifestyles, assuming a causal relationship. Participants with high genetic risk had a 36 % (20 %, 54 %) higher risk of CKD compared with those at low risk. Healthy lifestyle score significantly interacted with genetic risk (P_interaction = 0.02).

Both combined healthy lifestyles and genetic predisposition were independently associated with CKD risk. A healthy lifestyle pattern would modify the relationship between genetic predisposition and the risk of CKD.