| Title: | Association and Predictive Value of Biological Aging for Chronic Kidney Disease Risk in Diabetes: Cross-Cohort Validation across UK and China |
| Journal: | The Journals of Gerontology Series A |
| Published: | 8 May 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/42104203/ |
| DOI: | https://doi.org/10.1093/gerona/glag120 |
Publication 20126
WARNING: the interactive features of this website use CSS3, which your browser does not support. To use the full features of this website, please update your browser.
Abstract
BACKGROUND: Biological aging (BA) may influence chronic kidney disease (CKD) development. We evaluated the association of accelerated BA-quantified using Klemera-Doubal method biological age (KDM-BA) and phenotypic age (PhenoAge)-with incident CKD, and assessed its predictive value beyond conventional risk factors (CKD Prediction Consortium [CKD-PC] model) in participants with diabetes.</p>
METHODS: This two-country cohort study included 14,274 participants with diabetes from the UK Biobank and 7,900 from the China Renal Data System (CRDS). KDM-BA and PhenoAge were calculated from clinical biomarkers, and their acceleration (deviation from chronological age) was evaluated. Cox regression assessed associations with incident CKD, while C-index, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) evaluated predictive performance.</p>
RESULTS: Over median follow-ups of 13.3 (UK Biobank) and 3.3 (CRDS) years, 1,676 and 709 incident CKD cases were documented. Each standard deviation increase in KDM-BA acceleration was associated with 31% (95%CI: 23-39%) (UK) and 68% (95%CI: 58-80%) (China) higher CKD hazard. PhenoAge acceleration similarly increased CKD risk (29% and 28%, respectively). In the UK Biobank, adding KDM-BA or PhenoAge acceleration to the CKD-PC model (C-index = 0.770) led to modest but statistically significant improvements in prediction (C-index increase = 0.004 [95%CI: 0.002-0.006] and 0.003 [0.001-0.005], respectively), while leukocyte telomere length (LTL) provided no benefit (0.0001 [-0.0004, 0.0005]). Both BA measures enhanced reclassification (NRI: 0.034-0.076; IDI: 0.002-0.003). CRDS analyses yielded consistent results.</p>
CONCLUSION: Accelerated BA is consistently associated with higher CKD hazard in diabetes across European and Asian populations. KDM-BA and PhenoAge offer practical tools for refining CKD risk stratification.</p>
15 Authors
- Yiting Wu
- Hao Xiang
- Yu Huang
- Yuanyuan Zhang
- Ziliang Ye
- Yanjun Zhang
- Sisi Yang
- Xiaoqin Gan
- Yiwei Zhang
- Chen Dan
- Xianglian Cai
- Xiaolong Liang
- Sheng Nie
- Fan Fan Hou
- Xianhui Qin
1 Application
| Application ID | Title |
|---|---|
| 73201 | Identification of residual risks of non-infectious chronic diseases |
Enabling scientific discoveries that improve human health