Trends in Cardiovascular Mortality in Patients With Chronic Kidney Disease From 1999 to 2020: A Retrospective Study in the United States

Abstract

Background

Chronic kidney disease (CKD) may be associated with fatal cardiovascular diseases (CVDs). We aim to identify CVD-related mortality trends in patients with CKD in the US, examining the variation by sex, race, and region, and compare them to CVD-related mortality trends in general.

Methods

The CDC-WONDER database was used to obtain age-adjusted mortality rates (AAMRs) per 100,000 population. Annual percent change (APC) and average APC (AAPC) in these rates were calculated using Joinpoint regression and comparisons were done using pairwise comparison.

Results

From 1999 to 2020, a total of 605,384 CVD-related deaths were observed in patients with CKD. The AAMR was almost double in males (11.0) than females (6.3). NH (Non-Hispanic) Blacks or African Americans displayed the highest overall AAMR while NH Asians or Pacific Islanders displayed the lowest. AAMRs also varied substantially by region (Midwest: 8.8; West: 8.6; South: 8.0; Northeast: 7.3). States with the highest AAMR was the District of Columbia. Nonmetropolitan regions exhibited a slightly higher AAMR (8.6) than metropolitan regions (8.1). The AAPC for CVD-related deaths in patients with CKD differed significantly from that of the general population for the entire cohort, across both sexes, as well as among NH Whites, NH Black or African Americans, and Hispanics or Latinos. Regional differences were also observed in the Midwest, Northeast, and West.

Conclusion

Significant differences in CVD-related deaths in patients with CKD were observed. These high-risk groups should be the point of focus for targeted interventions to reduce CVD-related mortality in CKD patients.