ArticleJournal of diabetes and metabolic disorders2026
Diabetes mellitus and acute kidney failure-associated mortality in the United States: a retrospective analysis of CDC WONDER death records, 1999-2024.
Article in Journal of diabetes and metabolic disorders, 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
Purpose: To describe national trends in mortality involving both diabetes mellitus (DM) and acute kidney failure (AKF) among U.S. adults aged ≥55 years, including the COVID-19 period. Methods: Deaths listing both DM (ICD-10 E10-E14) and AKF (N17) during 1999-2024 were obtained from the CDC WONDER Multiple Cause of Death databases. Age-adjusted mortality rates (AAMRs) per 100,000 were stratified by demographic and geographic characteristics, and joinpoint regression estimated annual (APC) and average annual (AAPC) percent changes. Sensitivity analyses used underlying-cause definitions and excluded deaths listing COVID-19. Results: Among 206,290 deaths, the AAMR increased from 6.73 in 1999 to 13.90 in 2024 (AAPC 2.71%; 95% CI 1.54-3.88), rising until 2010, declining until 2018, increasing steeply from 2018 to 2021 (APC 32.96%), and declining thereafter. Mean AAMRs were higher in men than women (12.37 vs. 8.60), highest among non-Hispanic American Indian or Alaska Native (17.06) and Black (15.54) adults, lowest among non-Hispanic Asian or Pacific Islander adults (8.34), highest in the West (10.85) and South (10.76), and higher in nonmetropolitan areas (11.12 vs. 8.65). COVID-19 was listed on 17.4% of deaths during 2020-2024; excluding these deaths attenuated but did not eliminate the 2019-2022 increase (APC 23.25%), and the long-term increase persisted (AAPC 2.58%). Overall trends differed by cause-of-death definition. Conclusions: Mortality involving both DM and AKF approximately doubled between 1999 and 2024. The pandemic-era surge was not fully explained by deaths certified with COVID-19, and rates differed by sex, race and ethnicity, and geography. These descriptive findings may help to target individual-level research and kidney-protective diabetes care. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s40200-026-02128-7.
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