Temporal trends and demographic disparities in mortality from chronic renal failure with cerebrovascular disease as a contributing cause – a retrospective, population-based observational study in the United States, 1999-2020

Siddharth Mitra; Mani S. R. Challa; Harish Raj; Margi Panchal; Sakshi Solanki; Iman Moula

doi:10.18203/2320-6012.ijrms20263496

Authors

Siddharth Mitra Department of Medicine, Hinduhridaysamrat Balasaheb Thackeray Medical College and Dr. RN Cooper General Hospital, Mumbai, Maharashtra, India
Mani S. R. Challa Department of Medicine, Gayatri Vidya Parishad Institute of HealthCare and Medical Technology, Visakhapatnam, Andhra Pradesh, India
Harish Raj Department of Medicine, Meenakshi Medical College Hospital and Research Institute, Kanchipuram, Tamil Nadu, India
Margi Panchal Department of Medicine, Smt. NHL Municipal Medical College, Sardar Vallabhbhai Patel Institute of Medical Sciences and Research, Ahmedabad, Gujarat, India
Sakshi Solanki Department of Medicine, Rajiv Gandhi Medical College and Chhatrapati Shivaji Maharaj Hospital, Thane, Maharashtra, India
Iman Moula Department of Medicine, Kempegowda Institute of Medical Sciences, Bengaluru, Karnataka, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20263496

Keywords:

Chronic renal failure, Cerebrovascular diseases, Trends in mortality, Age-adjusted mortality rate, Retrospective study, CDC WONDER

Abstract

Background: Chronic renal failure (CRF) is a major cause of mortality worldwide. However, most studies focus on CRF alone and overlook the contribution of coexisting conditions.

Methods: A retrospective population-based study was conducted using the CDC wonder multiple cause of death database from 1999-2020. Deaths among U.S adults aged ≥25 years with chronic renal failure (ICD-10: n18) as the underlying cause and cerebrovascular disease (ICD-10: i60-i69) as a contributing cause were identified. Mortality trends were analyzed by sex, race, urbanization status, and place of death. Age-adjusted mortality rates and annual percentage changes were calculated using joinpoint regression analysis.

Results: A total of 22,719 deaths were identified, corresponding to a crude mortality rate of 5.1 per million population. The age adjusted mortality rate (AAMR) increased significantly from 2013-2020 (annual percentage changes (APC) +2.9%). Females accounted for 52.1% of deaths and males for 47.9%. Most deaths occurred among whites (68.7%) and black individuals (27.0%). Metropolitan areas accounted for 81.7% of deaths, while inpatient facilities represented the most common place of death (52.3%). Mortality increased among black populations from 2005 (APC +2.6%) and among whites from 2012 (APC +3.1%).

Conclusions: Mortality associated with CRF and cardiovascular disease (CVD) increased after 2013, with substantial disparities across racial, sex, and urbanization groups.

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