Abstract
Renal failure (RF) remains a major contributor to mortality in the United States, but how RF-related deaths have changed over time—and how those patterns differ across demographic and geographic groups—has not been well characterized. We used CDC WONDER multiple-cause-of-death data to examine RF-related mortality among U.S. adults aged ≥ 25 years from 1999 to 2023, defining RF as the underlying cause of death (ICD-10 N17–N19). We calculated age-adjusted mortality rates (AAMRs) per 100,000 and assessed temporal trends using joinpoint-derived average annual percent change (AAPC), overall and stratified by sex, age, race/ethnicity, U.S. census region, and urbanization. From 1999 to 2023, there were 1,138,750 RF-related deaths. Trends differed by region: the South consistently carried the highest burden and experienced the fastest increase in AAMR (AAPC = + 0.7605), whereas the Northeast showed a sustained decline (AAPC = − 0.5704). AAMRs were higher in females than in males throughout the study.