Application of the Life’s Essential 8 score in chronic kidney disease_West China Medical Journal

Authors：

ZHU Hongyun ^1,2 , PAN Xiaoyan ² , CHEN Xiangyu ³ , DAI Xiaoyu ^2,4 ,  ZHANG Xingyu ²

1. School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, P. R. China;
2. Department of Nephrology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan 621000, P. R. China;
3. Department of Nephrology, Renshou County People’s Hospital, Meishan, Sichuan 620500, P. R. China;
4. Department of Nephrology, Jiange County People’s Hospital, Guangyuan, Sichuan 628399, P. R. China;

Corresponding?author：

ZHANG Xingyu, Email: 568590255@qq.com

Keywords：

Chronic kidney disease; cardiovascular disease; Life’s Essential 8 score

DOI：

10.7507/1002-0179.202511002

Video：

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Chronic kidney disease (CKD) is a significant global public health challenge, with high overlap in etiological mechanisms and risk factors with cardiovascular diseases. The Life’s Essential 8 (LE8) score, as a comprehensive cardiovascular health assessment tool covering behavioral and metabolic indicators, has been used to measure an individual’s overall health status. This article reviews the application of LE8 total score and sub-indicator score in CKD, aiming to provide references for risk identification, prognosis evaluation, and comprehensive management of CKD.

Citation： ZHU Hongyun, PAN Xiaoyan, CHEN Xiangyu, DAI Xiaoyu, ZHANG Xingyu. Application of the Life’s Essential 8 score in chronic kidney disease. West China Medical Journal, 2026, 41(5): 851-855. doi: 10.7507/1002-0179.202511002 Copy

1.	Kidney Disease: Improving Global Outcomes (KDIGO) Glomerular Diseases Work Group. KDIGO 2021 clinical practice guideline for the management of glomerular diseases. Kidney Int, 2021, 100(4S): S1-S276.
2.	Ammirati AL. Chronic kidney disease. Rev Assoc Med Bras (1992), 2020, 66(Suppl 1): s03-s09.
3.	Farrell DR, Vassalotti JA. Screening, identifying, and treating chronic kidney disease: why, who, when, how, and what?. BMC Nephrol, 2024, 25(1): 34.
4.	Xie Y, Bowe B, Mokdad AH, et al. Analysis of the Global Burden of Disease study highlights the global, regional, and national trends of chronic kidney disease epidemiology from 1990 to 2016. Kidney Int, 2018, 94(3): 567-581.
5.	Bello AK, Okpechi IG, Levin A, et al. An update on the global disparities in kidney disease burden and care across world countries and regions. Lancet Glob Health, 2024, 12(3): e382-e395.
6.	Suriyong P, Ruengorn C, Shayakul C, et al. Prevalence of chronic kidney disease stages 3-5 in low- and middle-income countries in Asia: a systematic review and meta-analysis. PLoS One, 2022, 17(2): e0264393.
7.	Qing X, Jiang J, Yuan C, et al. Temporal trends in prevalence and disability of chronic kidney disease caused by specific etiologies: an analysis of the Global Burden of Disease Study 2019. J Nephrol, 2024, 37(3): 723-737.
8.	Ndumele CE, Rangaswami J, Chow SL, et al. Cardiovascular-kidney-metabolic health: a presidential advisory from the American Heart Association. Circulation, 2023, 148(20): 1606-1635.
9.	Vallianou NG, Mitesh S, Gkogkou A, et al. Chronic kidney disease and cardiovascular disease: is there any relationship?. Curr Cardiol Rev, 2019, 15(1): 55-63.
10.	Sebastian SA, Padda I, Johal G. Cardiovascular-kidney-metabolic (CKM) syndrome: a state-of-the-art review. Curr Probl Cardiol, 2024, 49(2): 102344.
11.	Aggarwal R, Ostrominski JW, Vaduganathan M. Prevalence of cardiovascular-kidney-metabolic syndrome stages in US adults, 2011-2020. JAMA, 2024, 331(21): 1858-1860.
12.	Li J, Lei L, Wang W, et al. Social risk profile and cardiovascular-kidney-metabolic syndrome in US adults. J Am Heart Assoc, 2024, 13(16): e034996.
13.	Zhu R, Wang R, He J, et al. Prevalence of cardiovascular-kidney-metabolic syndrome stages by social determinants of health. JAMA Netw Open, 2024, 7(11): e2445309.
14.	Marassi M, Fadini GP. The cardio-renal-metabolic connection: a review of the evidence. Cardiovasc Diabetol, 2023, 22(1): 195.
15.	Theofilis P, Vlachakis PK, Karakasis P, et al. Managing dyslipidemia in chronic kidney disease: implications for cardiovascular and renal risk. Curr Atheroscler Rep, 2025, 27(1): 41.
16.	Welsh A, Hammad M, Pi?a IL, et al. Obesity and cardiovascular health. Eur J Prev Cardiol, 2024, 31(8): 1026-1035.
17.	Jiang Z, Wang Y, Zhao X, et al. Obesity and chronic kidney disease. Am J Physiol Endocrinol Metab, 2023, 324(1): E24-E41.
18.	Miller MA, Howarth NE. Sleep and cardiovascular disease. Emerg Top Life Sci, 2023, 7(5): 457-466.
19.	Lindner AV, Novak M, Bohra M, et al. Insomnia in patients with chronic kidney disease. Semin Nephrol, 2015, 35(4): 359-372.
20.	Zhang N, Liu X, Wang L, et al. Lifestyle factors and their relative contributions to longitudinal progression of cardio-renal-metabolic multimorbidity: a prospective cohort study. Cardiovasc Diabetol, 2024, 23(1): 265.
21.	Rempakos A, Prescott B, Mitchell GF, et al. Association of Life’s Essential 8 with cardiovascular disease and mortality: the Framingham Heart Study. J Am Heart Assoc, 2023, 12(23): e030764.
22.	Ren Y, Cai Z, Guo C, et al. Associations between Life’s Essential 8 and chronic kidney disease. J Am Heart Assoc, 2023, 12(24): e030564.
23.	Han Y, Di H, Wang Y, et al. Association of the American Heart Association’s new “Life’s Essential 8” with all-cause mortality in patients with chronic kidney disease: a cohort study from the NHANES 2009-2016. BMC Public Health, 2024, 24(1): 1637.
24.	Chen H, Tang H, Huang J, et al. Life’s Essential 8 and mortality in US adults with chronic kidney disease. Am J Nephrol, 2023, 54(11/12): 516-527.
25.	Lloyd-Jones DM, Allen NB, Anderson CAM, et al. Life’s Essential 8: updating and enhancing the American Heart Association’s construct of cardiovascular health: a presidential advisory from the American Heart Association. Circulation, 2022, 146(5): e18-e43.
26.	Gao X, Ma X, Lin P, et al. Predictive value of cardiovascular health score for health outcomes in patients with PCI: comparison between Life’s Simple 7 and Life’s Essential 8. Int J Environ Res Public Health, 2023, 20(4): 3084.
27.	Shetty NS, Gaonkar M, Patel N, et al. Association of Life’s Essential 8 and Simple 7 Scores with mortality: comparison with pooled cohort equation. JACC Adv, 2024, 3(6): 100945.
28.	López-Bueno R, Calatayud J, Del Pozo Cruz J, et al. Dose-response associations of the American Heart Association’s new “Life’s essential 8” metrics with all-cause and cardiovascular mortality in a nationally representative sample from the United States. Prog Cardiovasc Dis, 2024, 85: 31-37.
29.	Li X, Ma H, Wang X, et al. Life’s Essential 8, genetic susceptibility, and incident cardiovascular disease: a prospective study. Arterioscler Thromb Vasc Biol, 2023, 43(7): 1324-1333.
30.	López-Bueno R, Nú?ez-Cortés R, Calatayud J, et al. Global prevalence of cardiovascular risk factors based on the Life’s Essential 8 score: an overview of systematic reviews and meta-analysis. Cardiovasc Res, 2024, 120(1): 13-33.
31.	Sun J, Li Y, Zhao M, et al. Association of the American Heart Association’s new “Life’s Essential 8” with all-cause and cardiovascular disease-specific mortality: prospective cohort study. BMC Med, 2023, 21(1): 116.
32.	Tang R, Wang X, Li X, et al. Adherence to Life’s Essential 8 and incident chronic kidney disease: a prospective study of 147, 988 UK Biobank participants. Am J Clin Nutr, 2023, 118(4): 804-811.
33.	Zhang Y, Ning N, Fan X, et al. Age-dependent interaction between Life’s Essential 8 and chronic kidney disease: a national cross-sectional analysis. Prev Med, 2023, 177: 107763.
34.	Chen W, Tang Y, Si Y, et al. Association of life’s essential 8 with prevalence and all-cause mortality of chronic kidney disease among US adults: results from the National Health and Nutrition Examination Survey (2015-2018). J Transl Int Med, 2025, 12(6): 581-591.
35.	Wang W, Zhang X, Zhang M, et al. Extreme temperature events, “Life’s Essential 8”, and prevalence of chronic kidney disease: a nationally representative surveillance in China. Environ Int, 2024, 194: 109176.
36.	Jankowski J, Floege J, Fliser D, et al. Cardiovascular disease in chronic kidney disease: pathophysiological insights and therapeutic options. Circulation, 2021, 143(11): 1157-1172.
37.	Schuett K, Marx N, Lehrke M. The cardio-kidney patient: epidemiology, clinical characteristics and therapy. Circ Res, 2023, 132(8): 902-914.
38.	Huo Z, Li J, Zhang S, et al. Association of Life’s Essential 8 with risk of incident cardiovascular disease and mortality among adults with chronic kidney disease. Am J Prev Cardiol, 2025, 22: 100994.
39.	Huo Z, Huang Z, Feng J, et al. Life’s Essential 8 and heart failure among patients with chronic kidney disease: the Kailuan Cohort Study. Eur J Prev Cardiol, 2024, 31(7): 824-831.
40.	Huang X, Liang J, Zhang J, et al. Association of Life’s Essential 8 with chronic cardiovascular-kidney disorder: a prospective cohort study. BMC Public Health, 2024, 24(1): 2448.

1. Kidney Disease: Improving Global Outcomes (KDIGO) Glomerular Diseases Work Group. KDIGO 2021 clinical practice guideline for the management of glomerular diseases. Kidney Int, 2021, 100(4S): S1-S276.
2. Ammirati AL. Chronic kidney disease. Rev Assoc Med Bras (1992), 2020, 66(Suppl 1): s03-s09.
3. Farrell DR, Vassalotti JA. Screening, identifying, and treating chronic kidney disease: why, who, when, how, and what?. BMC Nephrol, 2024, 25(1): 34.
4. Xie Y, Bowe B, Mokdad AH, et al. Analysis of the Global Burden of Disease study highlights the global, regional, and national trends of chronic kidney disease epidemiology from 1990 to 2016. Kidney Int, 2018, 94(3): 567-581.
5. Bello AK, Okpechi IG, Levin A, et al. An update on the global disparities in kidney disease burden and care across world countries and regions. Lancet Glob Health, 2024, 12(3): e382-e395.
6. Suriyong P, Ruengorn C, Shayakul C, et al. Prevalence of chronic kidney disease stages 3-5 in low- and middle-income countries in Asia: a systematic review and meta-analysis. PLoS One, 2022, 17(2): e0264393.
7. Qing X, Jiang J, Yuan C, et al. Temporal trends in prevalence and disability of chronic kidney disease caused by specific etiologies: an analysis of the Global Burden of Disease Study 2019. J Nephrol, 2024, 37(3): 723-737.
8. Ndumele CE, Rangaswami J, Chow SL, et al. Cardiovascular-kidney-metabolic health: a presidential advisory from the American Heart Association. Circulation, 2023, 148(20): 1606-1635.
9. Vallianou NG, Mitesh S, Gkogkou A, et al. Chronic kidney disease and cardiovascular disease: is there any relationship?. Curr Cardiol Rev, 2019, 15(1): 55-63.
10. Sebastian SA, Padda I, Johal G. Cardiovascular-kidney-metabolic (CKM) syndrome: a state-of-the-art review. Curr Probl Cardiol, 2024, 49(2): 102344.
11. Aggarwal R, Ostrominski JW, Vaduganathan M. Prevalence of cardiovascular-kidney-metabolic syndrome stages in US adults, 2011-2020. JAMA, 2024, 331(21): 1858-1860.
12. Li J, Lei L, Wang W, et al. Social risk profile and cardiovascular-kidney-metabolic syndrome in US adults. J Am Heart Assoc, 2024, 13(16): e034996.
13. Zhu R, Wang R, He J, et al. Prevalence of cardiovascular-kidney-metabolic syndrome stages by social determinants of health. JAMA Netw Open, 2024, 7(11): e2445309.
14. Marassi M, Fadini GP. The cardio-renal-metabolic connection: a review of the evidence. Cardiovasc Diabetol, 2023, 22(1): 195.
15. Theofilis P, Vlachakis PK, Karakasis P, et al. Managing dyslipidemia in chronic kidney disease: implications for cardiovascular and renal risk. Curr Atheroscler Rep, 2025, 27(1): 41.
16. Welsh A, Hammad M, Pi?a IL, et al. Obesity and cardiovascular health. Eur J Prev Cardiol, 2024, 31(8): 1026-1035.
17. Jiang Z, Wang Y, Zhao X, et al. Obesity and chronic kidney disease. Am J Physiol Endocrinol Metab, 2023, 324(1): E24-E41.
18. Miller MA, Howarth NE. Sleep and cardiovascular disease. Emerg Top Life Sci, 2023, 7(5): 457-466.
19. Lindner AV, Novak M, Bohra M, et al. Insomnia in patients with chronic kidney disease. Semin Nephrol, 2015, 35(4): 359-372.
20. Zhang N, Liu X, Wang L, et al. Lifestyle factors and their relative contributions to longitudinal progression of cardio-renal-metabolic multimorbidity: a prospective cohort study. Cardiovasc Diabetol, 2024, 23(1): 265.
21. Rempakos A, Prescott B, Mitchell GF, et al. Association of Life’s Essential 8 with cardiovascular disease and mortality: the Framingham Heart Study. J Am Heart Assoc, 2023, 12(23): e030764.
22. Ren Y, Cai Z, Guo C, et al. Associations between Life’s Essential 8 and chronic kidney disease. J Am Heart Assoc, 2023, 12(24): e030564.
23. Han Y, Di H, Wang Y, et al. Association of the American Heart Association’s new “Life’s Essential 8” with all-cause mortality in patients with chronic kidney disease: a cohort study from the NHANES 2009-2016. BMC Public Health, 2024, 24(1): 1637.
24. Chen H, Tang H, Huang J, et al. Life’s Essential 8 and mortality in US adults with chronic kidney disease. Am J Nephrol, 2023, 54(11/12): 516-527.
25. Lloyd-Jones DM, Allen NB, Anderson CAM, et al. Life’s Essential 8: updating and enhancing the American Heart Association’s construct of cardiovascular health: a presidential advisory from the American Heart Association. Circulation, 2022, 146(5): e18-e43.
26. Gao X, Ma X, Lin P, et al. Predictive value of cardiovascular health score for health outcomes in patients with PCI: comparison between Life’s Simple 7 and Life’s Essential 8. Int J Environ Res Public Health, 2023, 20(4): 3084.
27. Shetty NS, Gaonkar M, Patel N, et al. Association of Life’s Essential 8 and Simple 7 Scores with mortality: comparison with pooled cohort equation. JACC Adv, 2024, 3(6): 100945.
28. López-Bueno R, Calatayud J, Del Pozo Cruz J, et al. Dose-response associations of the American Heart Association’s new “Life’s essential 8” metrics with all-cause and cardiovascular mortality in a nationally representative sample from the United States. Prog Cardiovasc Dis, 2024, 85: 31-37.
29. Li X, Ma H, Wang X, et al. Life’s Essential 8, genetic susceptibility, and incident cardiovascular disease: a prospective study. Arterioscler Thromb Vasc Biol, 2023, 43(7): 1324-1333.
30. López-Bueno R, Nú?ez-Cortés R, Calatayud J, et al. Global prevalence of cardiovascular risk factors based on the Life’s Essential 8 score: an overview of systematic reviews and meta-analysis. Cardiovasc Res, 2024, 120(1): 13-33.
31. Sun J, Li Y, Zhao M, et al. Association of the American Heart Association’s new “Life’s Essential 8” with all-cause and cardiovascular disease-specific mortality: prospective cohort study. BMC Med, 2023, 21(1): 116.
32. Tang R, Wang X, Li X, et al. Adherence to Life’s Essential 8 and incident chronic kidney disease: a prospective study of 147, 988 UK Biobank participants. Am J Clin Nutr, 2023, 118(4): 804-811.
33. Zhang Y, Ning N, Fan X, et al. Age-dependent interaction between Life’s Essential 8 and chronic kidney disease: a national cross-sectional analysis. Prev Med, 2023, 177: 107763.
34. Chen W, Tang Y, Si Y, et al. Association of life’s essential 8 with prevalence and all-cause mortality of chronic kidney disease among US adults: results from the National Health and Nutrition Examination Survey (2015-2018). J Transl Int Med, 2025, 12(6): 581-591.
35. Wang W, Zhang X, Zhang M, et al. Extreme temperature events, “Life’s Essential 8”, and prevalence of chronic kidney disease: a nationally representative surveillance in China. Environ Int, 2024, 194: 109176.
36. Jankowski J, Floege J, Fliser D, et al. Cardiovascular disease in chronic kidney disease: pathophysiological insights and therapeutic options. Circulation, 2021, 143(11): 1157-1172.
37. Schuett K, Marx N, Lehrke M. The cardio-kidney patient: epidemiology, clinical characteristics and therapy. Circ Res, 2023, 132(8): 902-914.
38. Huo Z, Li J, Zhang S, et al. Association of Life’s Essential 8 with risk of incident cardiovascular disease and mortality among adults with chronic kidney disease. Am J Prev Cardiol, 2025, 22: 100994.
39. Huo Z, Huang Z, Feng J, et al. Life’s Essential 8 and heart failure among patients with chronic kidney disease: the Kailuan Cohort Study. Eur J Prev Cardiol, 2024, 31(7): 824-831.
40. Huang X, Liang J, Zhang J, et al. Association of Life’s Essential 8 with chronic cardiovascular-kidney disorder: a prospective cohort study. BMC Public Health, 2024, 24(1): 2448.

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