Abstract
Background: Kidney disease is a significant cause of morbidity and mortality in the United States. However, less is known about its burden specifically among older adults. Methods: We analyzed deaths among U.S. adults aged 65 and older between 2018 and 2023 where kidney disease was listed as the primary cause of death, using data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER). We examined overall and subgroup-specific death counts stratified by sex, race, ethnicity, and geographic location. Trends from 1999 to 2023 were also assessed. Results: Between 2018 and 2023, there were 263,436 deaths among adults aged 65+ with kidney disease as the primary cause, accounting for 81.5% of all kidney disease deaths during this period. Mortality rates were significantly higher among males compared to females (age-adjusted mortality rate (AAMR) ratio = 1.42, 95% CI: 1.42-1.43) and among Black Americans compared to White Americans (AAMR ratio = 1.94, 95% CI: 1.93-1.95). From 1999 to 2009, kidney disease mortality rates increased (annual percent change (APC) = 1.40, 95% CI: 0.90, 2.09), declined between 2009 and 2012 (APC = -5.35, 95% CI: -6.59, -2.33), and remained stable from 2012 to 2023. Conclusions: This majority of kidney disease deaths in the U.S. occur among older adults. While mortality briefly declined between 2009 and 2012, progress has since stalled. Persistent disparities by race and geography highlight the need for targeted research and interventions to reduce kidney disease mortality among older adults.