Abstract: FR-PO0246
Allostatic Load with CKD and Mortality in US Adults
Session Information
- CKD: Omics, Systemic Stressors, and Targeted Pharmacotherapy
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2201 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Wu, Jinshan, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Du, Xiaogang, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Background
CKD is a major health burden and the fifth leading cause of death worldwide. Chronic stress is relevant to metabolic disease, but its role in CKD remains unclear. Allostatic load (AL), a novel surrogate of chronic stress, has an undefined role in CKD and mortality risk within the general population. To evaluate the relationship between AL and the risks of CKD, and assess its predictive value in all-cause and cause-specific mortality among US adults.
Methods
This study used data from the National Health and Nutrition Examination Survey (NHANES) 1999-2010 and 2015-2018. Mortality data through December 31, 2019, were obtained by linkage to the National Death Index. Statistical analyses were conducted from June 1 to November 30, 2025. AL score (ALS) was calculated by summing eight biomarkers across the cardiovascular, metabolic, and immune systems. Participants were grouped by ALS (low (≤1), moderate (2) or high (≥3)). Main outcome of the cohort study was all-cause mortality. Cause-specific mortality was also examined. Weighted Cox proportional hazards regression models assessed the potential associations between ALS and mortality.
Results
The cross-sectional analysis included 36,198 participants (mean [SD] age, 49.56 [18.15] years; 18,695 [51.6%] female), the cohort analysis included 36,135 participants (mean [SD] age, 49.57 [18.15] years; 18,660 [51.6%] female). Higher ALS was significantly associated with increased CKD prevalence (aPR =1.32, 95% CI: 1.15-1.52). ALS also independently predicted renal-mortality (aHR = 2.25, 95% CI: 1.33-3.77) and all-cause (aHR = 1.44, 95% CI: 1.31-1.58) in the general population. Among CKD patients, a clear relationship was observed, with high ALS predicting cardiovascular mortality (aHR=1.74, 95% CI: 1.35–2.23) and all-cause (aHR=1.66, 95% CI: 1.43–1.93). In line with this, a multifactor-adjusted model accurately predicted 15-year mortality, with area-under-the-curve (AUC) values of 0.862 for all-cause mortality and 0.871 for cardiovascular mortality.
Conclusion
Higher baseline ALS was associated with an increased prevalence of CKD. ALS further independently predicted all-cause and cause-specific mortality, suggesting ALS may be a simple, reliable, cost-effective indicator for identifying individuals at high-risk of CKD and mortality in clinical practice.
Funding
- Government Support – Non-U.S.