Study Population

This study used data from population-based cohorts in the Korean Genome and Epidemiology Study (KoGES): KoGES_Ansan and Ansung study (community-based cohort in urban and rural counites), the KoGES_health examinee study (national health examinee registry), and the KoGES_cardiovascular disease association study (community-based cohort in rural counties). Participants were recruited through on-site invitation, mailed letters, telephone calls, media campaigns, or community leader-mediated conferences. In KoGES_Ansan and Ansung study, a total of 10,030 participants aged 40–69 years was voluntarily enrolled at baseline between 2001 and 2002. In the KoGES_health examinee study, a total of 173,357 participants was enrolled at baseline from 2004 to 2013. In the KoGES_cardiovascular disease association study, a total of 28,338 participants was enrolled at baseline from 2005 to 2011. A total of 211,571 participants aged over 40 years was enrolled at the baseline KoGES survey. We excluded participants with missing lifestyle (n = 2,231), laboratory test (n = 5,853), and nutritional intake (n = 14,007) data and implausible daily total calorie intakes (<500 kcal or >6,000 kcal). Excluding 54,530 participants with missing mortality data and 63 participants who died in their year of enrollment, a total of 143,050 participants were selected. Finally, a total of 3,892 participants with an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m² were included in the analysis. Among the 3,892 participants, 602 deaths were documented during the follow-up time. The study population selection process is depicted in Supplementary Figure 1. Written informed consent documents were signed by all participants. The study protocol conformed to the ethical guidelines of the 1975 Declaration of Helsinki. This study was approved by the institutional review boards of Yongin Severance Hospital (IRB Number: 9-2021-0066).