Kidney Week

Abstract: SA-PO0408

Associations of Life's Simple 7 with Kidney Tubular and Glomerular Measures in Cross-Section and over 10 Years in Community-Living Individuals

Session Information

• CKM: Clinical - Epidemiology and Outcomes
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Cardiovascular-Kidney-Metabolic Health

• 602 Cardiovascular-Kidney-Metabolic Health: Clinical

Authors

• Postalcioglu, Merve, University of California San Francisco, San Francisco, California, United States

Merve Postalcioglu, MD, FASN

• Katz, Ronit, University of Washington, Seattle, Washington, United States

Ronit Katz, PhD

• Sarnak, Mark J., Tufts Medical Center, Boston, Massachusetts, United States

Mark J. Sarnak, MD, MS

• Ix, Joachim H., University of California San Diego, La Jolla, California, United States

Joachim H. Ix, MD, FASN

• Shlipak, Michael G., University of California San Francisco, San Francisco, California, United States

Michael G. Shlipak, MD, MPH

• Gutierrez, Orlando M., University of Alabama at Birmingham Health System, Birmingham, Alabama, United States

Orlando M. Gutierrez, MD

Background

Chronic kidney disease (CKD) is a major risk factor for cardiovascular disease (CVD). Kidney tubular health may represent an underrecognized mechanistic link.

Methods

Within random subsets from the CARDIA and MESA cohorts (N=1831; CARDIA n=817; MESA n=1014), we assessed Life’s Simple 7 (LS7). LS7 includes diet, physical activity, smoking, BMI, blood pressure, cholesterol, and glucose, and was scored 0–14 (higher scores indicate better CV health) and categorized as low (0–7), moderate (8–11), or high (12–14). Seven kidney tubule biomarkers were measured in urine at baseline and 10-year follow-up and grouped into tubular injury (IL-18, KIM-1, MCP-1, YKL-40), synthetic function (EGF, UMOD), and reabsorptive function (α1m) using factor analysis. Associations of LS7 with these groups were compared in strength with albuminuria and eGFR. Linear and mixed-effects models were used to assess cross-sectional and longitudinal associations, respectively.

Results

Mean age was 45±4 years in CARDIA and 63±10 years in MESA. Mean eGFR was 96±15 and 78±16 mL/min/1.73m2, and median UACR was 4 [3, 8] and 5 [3, 11] mg/g respectively. At baseline, lower (worse) LS7 scores were associated with worse tubular injury, synthetic and reabsorptive function, and higher albuminuria, but not eGFR (Table). Over 10 years, longitudinal associations were consistent across factor-based measures of tubular synthetic and reabsorptive function; associations with albuminuria were attenuated, while associations with eGFR were observed.

Conclusion

Lifestyle factors known to lead to CVD are associated with progressively worsening tubular function and injury with comparable magnitude to the effects observed for albuminuria and eGFR.

Funding

• NIDDK Support