Abstract 4342735: Trends in Chronic Kidney Disease Related Mortality Among Heart Failure Patients (1999–2023) in the United States

Abstract

INTRODUCTION: Heart failure (HF) contributes to the progression and worsening of chronic kidney disease (CKD) by mechanisms like reduced renal perfusion and neurohormonal activation, increasing mortality risk. Our study analyzes trends in CKD mortality among patients with HF in the United States from 1999 to 2023. METHODS: Death records from the Centers for Disease Control and Prevention’s Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database (1999–2023) included patients aged 45 and above having CKD as the underlying cause of death and HF listed as a contributing cause. Age-adjusted mortality rates (AAMRs) per 100,000 population were analyzed, and temporal trends were assessed using Joinpoint regression to calculate the annual percent change (APC). RESULTS: From 1999 to 2023, a total of 107,259 deaths occurred from CKD in patients with HF. AAMR rose almost 2 times from 2.4 in 1999 to 4.8 in 2023, showing a prominent increase shift from 2009 to 2018 (APC: 6.18; 95% CI: 5.16 to 9.50). AAMR in males (4.4) reported by 2023 was twice that of females (2.8). NH African Americans (5.8) recorded doubled the AAMRs compared to other racial/ethnic groups. Mortality rates among older adults (8.6) were 16 times higher than middle-aged adults (0.5). Rates were also notably high in non-metropolitan areas (3.9) and the Midwest regions (4.0). CONCLUSION: HF complicates CKD management and contributes significantly to CKD-related mortality. Rising AAMR trends across geographic and demographic groups highlight the need for targeted interventions and proper resource allocation to reduce this dual burden.