Temporal trends in mortality involving chronic lower respiratory disease and chronic kidney disease: evidence from CDC WONDER, 1999-2023.

BACKGROUND

Chronic Lower Respiratory Disease (CLRD) and chronic kidney disease (CKD) are comorbid progressive diseases that have, over the decades, significantly contributed to high mortality rates. The overlapping mechanisms are aggravated by their coexistence, thus resulting in a poorer prognosis. The purpose of the study is to examine countrywide mortality rates related to CLRD and CKD and to identify the disparities among various population groups.

METHODS

The CDC WONDER database was used to discuss age-adjusted mortality rates (AAMRs) of CLRD among patients with chronic kidney disease aged 25 and older, in 1999-2023, by sex and race, by geography, and by metropolitan status. Joinpoint regression was used to calculate Average Annual Percentage Changes (AAPCs) and Annual Percentage Changes (APCs) per 100,000 with 95% confidence intervals (CI).

RESULTS

There were 242,665 deaths among CKD patients with CLRD between 1999 and 2023. The age-adjusted mortality rate (AAMR) increased from 2.53 (95% CI: 2.46-2.61) in 1999 to 5.07 (95% CI: 4.99-5.16) in 2023, with an overall AAPC of 3.11% (95% CI: 1.91-4.32; p < 0.001). Men had higher AAMRs throughout the study period (AAPC: 2.04%; p = 0.002), while women showed a steeper increase over time (AAPC: 4.26%; p < 0.001). Among racial groups, non-Hispanic Whites had the highest mortality rates (AAPC: 3.62%; p < 0.001). The highest mortality burden was observed in individuals aged ≥ 85 years (AAPC: 4.93%; p < 0.001). Geographically, the Midwest region showed significant increases (AAPC: 3.52%; p < 0.001), with higher mortality observed in non-metropolitan areas (AAPC: 4.20%; p < 0.001).

CONCLUSION

The documented gaps highlight the need to improve healthcare policies, eliminate gaps in coverage, and propagate education and awareness to decrease mortalities. The reduction of the mortalities is essential through addressing the inequalities in healthcare access and increasing health initiatives.