Nabi Rayyan, Akhtar Muzamil, Rath Shree, Farooqi Hanzala Ahmed, Awais Abdul Raffay, Abbasi Sabahat Ul Ain Munir, Ahmed Saeed, Collins Peter, Ahmed Raheel, Zahid Tabeer, Nabi Zahid
Islamic International Medical College, 332, Street 12, Phase 4, Bahria Town, Rawalpindi, Punjab, Pakistan.
Gujranwala Medical College, Gujranwala, Punjab, Pakistan.
Int Urol Nephrol. 2025 Apr 25. doi: 10.1007/s11255-025-04534-x.
Heart failure (HF) and acute kidney injury (AKI) are leading contributors to morbidity and mortality in the United States, often coexisting as part of the cardiorenal syndrome. Understanding long-term mortality trends is crucial for guiding healthcare policies and interventions. This study analyses national trends in HF- and AKI-related mortality from 1999 to 2020, with a focus on age-adjusted mortality rates (AAMR) and disparities across gender, race/ethnicity, urbanization, and geographic regions.
We conducted a retrospective analysis using the CDC WONDER database, extracting mortality data for adults aged 25-85 years. HF- and AKI-related deaths were identified using ICD-10 codes. Temporal trends in AAMR were evaluated using Joinpoint regression, and subgroup analyses were performed to assess disparities.
A total of 219,243 HF- and AKI-related deaths were recorded. The overall AAMR increased from 3.56 per 100,000 in 1999 to 5.30 in 2020 (AAPC: 1.52%; p < 0.001). Males had a higher AAMR than females (5.80 vs. 3.84). NH Black individuals exhibited the steepest rise in mortality, whereas NH White and Asian populations showed stabilization. Nonmetropolitan areas had higher AAMRs compared to metropolitan regions. State-level disparities revealed that North Dakota and West Virginia had the highest mortality rates, whereas Florida and Arizona had the lowest.
HF- and AKI-related mortality has risen significantly over the past two decades, with pronounced disparities across demographic and geographic subgroups. These findings underscore the need for targeted interventions to address healthcare inequities and improve outcomes in high-risk populations.
心力衰竭（HF）和急性肾损伤（AKI）是美国发病和死亡的主要原因，常作为心肾综合征的一部分同时存在。了解长期死亡率趋势对于指导医疗政策和干预措施至关重要。本研究分析了1999年至2020年与HF和AKI相关的全国死亡率趋势，重点关注年龄调整死亡率（AAMR）以及性别、种族/族裔、城市化程度和地理区域之间的差异。
我们使用疾病控制与预防中心（CDC）的WONDER数据库进行了一项回顾性分析，提取了25至85岁成年人的死亡率数据。使用国际疾病分类第十版（ICD - 10）编码确定与HF和AKI相关的死亡。使用Joinpoint回归评估AAMR的时间趋势，并进行亚组分析以评估差异。
共记录了219,243例与HF和AKI相关的死亡。总体AAMR从1999年的每10万人3.56例增加到2020年的5.30例（年度百分比变化：1.52%；p < 0.001）。男性的AAMR高于女性（5.80对3.84）。非西班牙裔黑人个体的死亡率上升最为显著，而非西班牙裔白人和亚洲人群的死亡率则趋于稳定。与大都市地区相比，非大都市地区的AAMR更高。州级差异显示，北达科他州和西弗吉尼亚州的死亡率最高，而佛罗里达州和亚利桑那州的死亡率最低。
在过去二十年中，与HF和AKI相关的死亡率显著上升，不同人口统计学和地理亚组之间存在明显差异。这些发现强调了需要采取有针对性的干预措施来解决医疗保健不平等问题，并改善高危人群的结局。
