ArticleThe Journal of international medical research2026
Long-term mortality trends and disparities in renal failure across the United States, 1999 to 2024: A nationwide population-based ecological time-trend study.
Article in The Journal of international medical research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
ObjectiveAlthough renal failure is an important cause of death in the United States, recent mortality trends and subgroup differences remain insufficiently characterized. This nationwide ecological time-trend study examined renal failure mortality among adults in the United States from 1999 to 2024 by sex, age, race and ethnicity, region, state, urbanization level, and renal failure subtype.MethodsDeaths among adults aged ≥25 years with renal failure as the underlying cause of death were identified from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database. Renal failure was defined using International Classification of Diseases, Tenth Revision codes N17 to N19. Primary measures were age-adjusted mortality rate and average annual percent change. Subtype analyses were performed for acute, chronic, and unspecified renal failure.ResultsFrom 1999 to 2024, 1,192,598 deaths were attributed to renal failure. Annual deaths increased from 34,456 to 53,848, whereas age-adjusted mortality rate changed only modestly from 19.57 to 19.05 per 100,000 population, with an average annual percent change of -0.16 (95% confidence interval, -0.62 to 0.30). In 2024, males had a higher age-adjusted mortality rate than females (22.72 vs. 16.26), and non-Hispanic Black individuals exhibited the highest age-adjusted mortality rate (37.53). Adults aged 45-54 years showed a significant long-term increase. Subtype analyses revealed increasing chronic renal failure, a nonsignificant increase in acute renal failure, and markedly declining unspecified renal failure.ConclusionsAlthough overall renal failure age-adjusted mortality rate remained largely stable from 1999 to 2024, this pattern masked divergent subtype trends and persistent subgroup disparities. Higher rates among males, non-Hispanic Black individuals, and nonmetropolitan populations suggest that gaps have not narrowed sufficiently, likely reflecting unequal cardiometabolic risk burden, delayed detection, and uneven access to kidney care. Prevention strategies should prioritize high burden communities and improve early chronic kidney disease recognition, risk factor control, and access to nephrology care.
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