Introduction: Sepsis, responsible for 1 in 3 hospital deaths in the United States, becomes even more deadly in patients with chronic kidney disease (CKD), which affects nearly one-third of the elderly population. However, little is known about the long-term effects of CKD on sepsis mortality in older adults, despite its clinical significance. Using national death records, this study examines two decades of mortality trends (1999–2023) among U.S. adults aged 65 and older with both CKD and sepsis Methods: Retrospective analysis of mortality data was conducted using the open-access CDC-WONDER database in the USA from 1999 to 2023. Patients aged 65 or older with CKD and sepsis were identified using ICD-10 codes for Sepsis (A02-41 and B37.7) and renal failure (N00–N19). Results were stratified by geographic location and demographics. Age-adjusted mortality rates (AAMRs) were calculated per 100,000 people by standardizing cause-specific mortality rates (CMRs) with 95% confidence intervals. Annual percent change (APC) and average annual percent change (AAPC) were determined using Joinpoint regression software. Grammar check software was utilized in all written material. Results: A total of 66,213 deaths related to kidney failure and sepsis occurred among adults aged 65 or older in the United States from 1999 to 2023. Most deaths took place in medical facilities (88.37%), followed by nursing homes/facilities, hospitals, and the decedent’s home. Overall, AAMRs increased from 54.39 in 1999 to 71.47 in 2023 (APC: 8.69). Men had a higher average AAMR (75.04) compared to women (51.93). Non-Hispanic Whites exhibited the highest AAPC, while Blacks had the highest AAMR. Metropolitan areas showed higher AAMRs, with rural areas experiencing a rising trend. The South had the highest AAMR (68.09), and the West showed the most significant rate of increase. Conclusions: Despite overall healthcare advances haven’t stopped the rise in sepsis-related deaths among older patients with renal disease over 20 years, with disparities across sex, race, region, and location. Higher mortality in men, non-Hispanic blacks, urban, and southern residents emphasizes the need for targeted strategies, equitable resources, and early detection to prevent avoidable deaths
Memon et al. (Sun,) studied this question.