Abstract
BACKGROUND: Chronic kidney disease (CKD) is becoming increasingly common in the United States, particularly among older adults. However, little is known about the mortality patterns within this demographic. OBJECTIVE: This study aims to explore the demographic and regional patterns of CKD-associated mortality in the United States from 1999 to 2020 among adults >65 years old. METHODS: The Centers for Disease Control and Prevention's WONDER (Wide-Ranging Online Data for Epidemiologic Research) database's death certificates were analyzed for CKD-related mortality in persons aged 65 and older between 1999 and 2020. Age-adjusted mortality rates (AAMRs) per 10 000 and annual percentage change were calculated, stratified by geographic region, sex, year, and race/ethnicity. RESULTS: Between 1999 and 2020, 1 572 075 CKD-related deaths occurred among adults ≥65 years. AAMR increased significantly from 132.0 in 1999 to 216.6 in 2020. Men consistently had higher AAMRs than women. Non-Hispanic (NH) Black has the highest AAMR (312.3), followed by NH American Indian (188.8), Hispanic (178), NH White (157), and NH Asian (143.9). Additionally, there was significant regional heterogeneity in AAMR (Midwest 184.6; South: 171.6; West: 165.5; Northeast: 157.4), with CKD-related AAMR being greater in non-metropolitan areas. States with CKD-related rates in the top 90th percentile AAMR were West Virginia, North Dakota, Indiana, Ohio, South Carolina, and North Carolina. CONCLUSIONS: CKD-related mortality in US adults ≥65 years has increased from 1999 to 2020. The highest AAMRs were noticed among NH Blacks, men, and patients residing in non-metropolitan and Midwestern areas of the United States. A targeted approach is required to significantly decrease the mortality in this population group.