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June 21, 2026Open Access

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

Puntos clave

The aim is to examine mortality rates related to chronic lower respiratory disease and chronic kidney disease and identify disparities across populations.
Analyzed CDC WONDER database for age-adjusted mortality rates from 1999 to 2023.
Employed joinpoint regression to calculate average annual percentage changes and annual percentage changes.
Sample included 242,665 deaths among CKD patients with CLRD over the specified period.
Age-adjusted mortality rate increased from 2.53 (95% CI: 2.46–2.61) in 1999 to 5.07 (95% CI: 4.99–5.16) in 2023, AAPC 3.11% (95% CI: 1.91–4.32; p < 0.001).
Higher mortality rates observed in men (AAPC: 2.04%; p = 0.002) and a steeper increase in women (AAPC: 4.26%; p < 0.001).
Midwest region showed significant increases (AAPC: 3.52%; p < 0.001) with higher mortality in non-metropolitan areas (AAPC: 4.20%; p < 0.001).

Resumen

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. 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). 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). 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.

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