Objective This study aims to investigate the association between docosanoic acid (DA) in human circulation and the risk of occurrence and mortality of chronic kidney disease (CKD). Methods This is a cross-sectional study including individuals in NHANES 2011-2014. RCS were used to fit the dose-effect curve between DA levels and CKD risk in the general population, and mortality in CKD patients. Multiple logistic and Cox regressions were used to analyze the association of DA with CKD occurrence and mortality risks respectively. Results A total of 2,366 participants were included in this study, including 1,958 (82.8%) individuals without CKD and 408 (17.2%) CKD individuals. The RCS results showed a linear association between DA and the risk of CKD in individuals. Per standard deviation (per-SD) increase in DA, the risk of CKD in the general population decreased by 18% (OR = 0.82; 95% CI, 0.70 - 0.96; P = 0.02). In addition, the RCS results showed a linear association between DA and the risk of cardiovascular and all-cause mortality in CKD. Multivariate Cox regression analysis showed that per-SD increase in DA, the risk of cardiovascular mortality in CKD patients decreased by 44% (HR = 0.56; 95% CI, 0.35 - 0.90; P = 0.02) and all-cause mortality decreased by 27% (HR = 0.73; 95% CI, 0.59 - 0.89; P = 0.002). Conclusion Higher serum DA in populations means lower CKD risk. Moreover, for CKD patients, as DA levels increase, the risk of cardiovascular and all-cause mortality decreases.

The authors have declared no competing interest.

The Science and technology fund of Chengdu Medical College (CYZYB22-02). The research fund of Sichuan Medical and Health Care Promotion institute (KY2022QN0309). The Sichuan Provincial Medical Association Youth Innovation Project (Q23021). The Sichuan Province Science and Technology Project (No. 2023NSFSC1529).

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