Key result
Concurrent AF and CKD mortality rises nearly 8-fold in the U.S. over 25 years.
Why the study?
Atrial fibrillation and chronic kidney disease frequently co-occur and worsen adverse outcomes and mortality, prompting an evaluation of AF and CKD-related mortality trends and disparities in the United States from 1999 to 2024.
Observational (n=207,853)
Answers are grounded in this paper and cite their sources.
Mortality related to concurrent atrial fibrillation and chronic kidney disease in the United States increased nearly 8-fold between 1999 and 2024, disproportionately affecting men, non-Hispanic Whites, older adults, and rural populations.
BACKGROUND: Atrial fibrillation (AF) and chronic kidney disease (CKD) are conditions that frequently co-occur and worsen the adverse outcomes associated with each condition, leading to increased mortality. We evaluated AF and CKD-related mortality trends and disparities in the U.S. from 1999 to 2024. METHODS: Data for individuals listing both AF and CKD as either underlying or contributing cause of death were extracted from the CDC WONDER database between 1999 and 2024, and age-adjusted mortality rates (AAMRs) were computed per 100,000 population of various demographic and geographic subgroups. The temporal mortality trends were represented by the annual percent changes (APCs) in AAMR calculated through the joinpoint regression program. RESULTS: A total of 207,853 AF-CKD-related deaths were reported, with AAMR increasing significantly from 0.79 in 1999 to 6.03 in 2024, driven predominantly by a sharp rise from 2011 to 2024 (APC: 4.25). Males consistently exhibited higher rates than females (4.02 vs. 2.24; APC: 4.13 vs. 4.19, respectively; both P < 0.05). Among races/ethnicities, mortality rates were highest in non-Hispanic (NH) Whites (3.01; APC: 4.83; P < 0.05), followed by NH African Americans (2.98; APC: 7.63; P < 0.05), NH American Indians (2.62), and lowest in NH Asians/Pacific Islanders and Hispanics (1.87 each), with Hispanics showing a sharp recent decline (APC: -8.39; P < 0.05). Adults aged ≥85 years (CMR: 60.55) had the highest mortality, while the 55-64 age group exhibited the fastest recent increase (APC: 5.37; P < 0.05), followed by the 85+ (APC: 5.10; P < 0.05), 65-74 (APC: 3.49; P < 0.05), and 75-84 (APC: 3.08; P < 0.05) age groups. Geographically, the Midwest (3.7) and non-metropolitan regions (3.2) recorded the highest AAMRs, with both metropolitan and non-metropolitan areas showing significant increases over time (APC: 9.38 and 9.55, respectively; both P < 0.05). CONCLUSION: AF-CKD-related mortality rose nearly 8-fold over 25 years, with the highest burden among men, NH Whites, older adults, and rural populations, highlighting an urgent need for targeted cardiorenal care and integrated surveillance strategies.
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Hassan et al. (2026) conducted an observational in Concurrent atrial fibrillation and chronic kidney disease (n=207,853). Concurrent atrial fibrillation and chronic kidney disease vs. Demographic and geographic subgroups across time (1999 vs 2024) was evaluated on Age-adjusted mortality rate (AAMR) per 100,000 population for concurrent AF and CKD (APC 4.25 (from 2011 to 2024)). Concurrent AF and CKD mortality in the U.S. rose nearly 8-fold over 25 years, with the age-adjusted mortality rate increasing from 0.79 in 1999 to 6.03 in 2024 (2011-2024 APC: 4.25).
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