This study has important clinical and public health implications. Understanding the interplay between TL and kidney function is a necessary and important step toward any application of the resulting knowledge for public health policy and action. Moreover we knew that CKD may increase the risk of CVD as leading cause of the death which may could be explain by role of the TL [27–29]. Our study provides a comprehensive snapshot of the relationship of kidney function with TL at the national level in the US.