Kidney disease related mortality: Trends and disparities among patients with multiple myeloma.

Abstract

e19562 Background: Kidney disease is a common and severe comorbidity among patients with multiple myeloma, significantly impacting outcomes and mortality. Disparities in kidney disease-related mortality across demographic, geographic, and socioeconomic factors remain underexplored. Methods: We analyzed CDC Wide-Ranging Online Data (1999–2020) to assess trends and disparities in kidney disease-related mortality among patients with multiple myeloma, stratified by sex, ethnicity, census regions, and urbanization. Age-adjusted mortality rates (AAMR) per 100,000 and annual percent change (APC) were calculated using Joinpoint Software. Results: From 1999 to 2020, the AAMR for multiple myeloma patients with kidney disease showed significant disparities. The mean AAMR was 0.96 (CI: 0.7–1.2) for males and 0.55 (CI: 0.4–0.7) for females. Among females, notable APCs included an increase from 1999 to 2005 (+2.37%) and a decline from 2005 to 2008 (−12.23%). Black patients had the highest mean AAMR (1.61; CI: 1.1–2.3), followed by White (0.64; CI: 0.5–0.8) and Asian or Pacific Islander (0.39; CI: 0.2–0.6). Black patients experienced significant declines from 2003 to 2009 (APC −6.33; p<0.05) and 2012 to 2018 (APC −5.66; p<0.05). The mean AAMR for non-Hispanics (0.73; CI: 0.5–0.9) was higher than for Hispanics (0.61; CI: 0.4–0.9), with Hispanics showing a sharp decline from 2012 to 2015 (APC −8.71%) and a subsequent decrease from 2018 to 2020 (APC −10.66%). AAMRs were highest in medium metro (0.75; CI: 0.6–0.9) and micropolitan areas (0.74; CI: 0.6–0.9), with significant declines in medium metros from 2012 to 2015 (APC −7.18; p<0.05). Regional disparities revealed the highest AAMRs in the Midwest and South (both 0.74; CI: 0.6–0.9), with significant declines in the South from 2012 to 2018 (APC −4.91; p<0.05). Conclusions: Our findings reveal significant disparities in kidney disease-related mortality among multiple myeloma patients. Mortality rates were consistently higher among males, African American patients, and those in medium metro and micropolitan areas. Temporal trends indicated periods of steep increases and declines, varying across demographic and geographic strata. These results underscore the need for tailored interventions to address specific at-risk populations and reduce health disparities. Stratification Mean AAMR (per 100,000) Confidence Interval Key APC Trends Notable APC (%) Male 0.96 0.7–1.2 1999–2005: Increase 2.37 Female 0.55 0.4–0.7 2005–2008: Decline −12.23 Black/African American 1.61 1.1–2.3 1999–2002: Decline −9.09 Hispanic 0.61 0.4–0.9 2018–2020: Decline −10.66 Non-Hispanic 0.73 0.5–0.9 — — Medium Metro 0.75 0.6–0.9 2005–2008: Decline −9.80 Large Central Metro 0.74 0.5–1.0 2008–2011: Increase 3.41 Midwest 0.74 0.6–0.9 — — Northeast 0.69 0.4–0.9 2015–2018: Decline −12.27