Kidney failure-related excess mortality during the first three years of the COVID-19 pandemic in the United States: a nation-wide, population-based analysis
Abstract Background The onset of the COVID-19 pandemic has had a detrimental impact on the healthcare system. Patients with kidney failure and related kidney disease are notably vulnerable to the COVID-19 pandemic. However, it remains unclear how mortality trends associated with kidney failure have...
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BMC
2025-01-01
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| Series: | BMC Public Health |
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| Online Access: | https://doi.org/10.1186/s12889-025-21422-2 |
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| author | Zhenhu Chen Pingping Jia Di Xie Jingyu Xie Juan Liu Wangnan Cao Lefei Han Jinjun Ran Shengzhi Sun Shi Zhao Yang Ge Leonardo Martinez Xin Chen Peihua Cao |
| author_facet | Zhenhu Chen Pingping Jia Di Xie Jingyu Xie Juan Liu Wangnan Cao Lefei Han Jinjun Ran Shengzhi Sun Shi Zhao Yang Ge Leonardo Martinez Xin Chen Peihua Cao |
| author_sort | Zhenhu Chen |
| collection | DOAJ |
| description | Abstract Background The onset of the COVID-19 pandemic has had a detrimental impact on the healthcare system. Patients with kidney failure and related kidney disease are notably vulnerable to the COVID-19 pandemic. However, it remains unclear how mortality trends associated with kidney failure have evolved over the past three years. In this study, we investigated temporal trends in excess kidney failure-related mortality during the first three years of the pandemic in the United States. Methods We aim to estimate time-varying excess kidney failure-related mortality, which is defined as the difference between observed mortality and expected mortality predicted by a Poisson log-linear regression model, in the United States (March 2020—March 2023). Results Our findings revealed two distinct peaks in excess kidney failure-related mortality during the first year (March 2020—February 2021) and the second year (February 2021—March 2022), whereas a notable decline in excess mortality was observed in the third year (March 2022—March 2023). Additionally, disparities in mortality were evident among various demographic groups, including age, sex, racial/ethnic subgroups, and geographic regions. Across all age subgroups, an increase in kidney failure-related mortalities was observed, with individuals aged 85 years and above experiencing the most substantial relative increase, reaching 9595.8 per million persons (95% CI: 9438.8, 9752.9). Moreover, excess kidney failure-related mortalities were recorded at 510.3 per million persons (95% CI: 502.6, 517.9) and 721.8 per million persons (95% CI: 713.4, 730.1) for women and men, respectively. Notably, non-Hispanic Blacks exhibited the highest excess mortality within the racial/ethnic group, registering at 772.6 per million persons (95% CI: 756.3, 788.9). Conclusions Our study observed high levels of excess kidney failure-related mortality during the first two years of the pandemic, followed by a notable decline in the third year. This highlights the effectiveness of current policies and prevention measures implemented to mitigate the impact of the pandemic. |
| format | Article |
| id | doaj-art-c862fa1e0bba40b1b9ee4f5c95fc08e1 |
| institution | Kabale University |
| issn | 1471-2458 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj-art-c862fa1e0bba40b1b9ee4f5c95fc08e12025-01-26T12:55:36ZengBMCBMC Public Health1471-24582025-01-0125111010.1186/s12889-025-21422-2Kidney failure-related excess mortality during the first three years of the COVID-19 pandemic in the United States: a nation-wide, population-based analysisZhenhu Chen0Pingping Jia1Di Xie2Jingyu Xie3Juan Liu4Wangnan Cao5Lefei Han6Jinjun Ran7Shengzhi Sun8Shi Zhao9Yang Ge10Leonardo Martinez11Xin Chen12Peihua Cao13Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical UniversityCenter for Clinical and Epidemiologic Research, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel DiseasesDivision of Nephrology, Nanfang Hospital, Southern Medical UniversityDepartment of Population and Public Health Sciences, Center for Genetic Epidemiology, Keck School of Medicine, University of Southern CaliforniaDepartment of Biostatistics, School of Public Health, Southern Medical UniversityDepartment of Social Medicine and Health Education, School of Public Health, Peking UniversitySchool of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of MedicineSchool of Public Health, Shanghai Jiao Tong University School of MedicineSchool of Public Health, Capital Medical UniversityJC School of Public Health and Primary Care, Chinese University of Hong KongSchool of Health Professions, University of Southern MississippiDepartment of Epidemiology, School of Public Health, Boston UniversityDepartment of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical UniversityDepartment of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical UniversityAbstract Background The onset of the COVID-19 pandemic has had a detrimental impact on the healthcare system. Patients with kidney failure and related kidney disease are notably vulnerable to the COVID-19 pandemic. However, it remains unclear how mortality trends associated with kidney failure have evolved over the past three years. In this study, we investigated temporal trends in excess kidney failure-related mortality during the first three years of the pandemic in the United States. Methods We aim to estimate time-varying excess kidney failure-related mortality, which is defined as the difference between observed mortality and expected mortality predicted by a Poisson log-linear regression model, in the United States (March 2020—March 2023). Results Our findings revealed two distinct peaks in excess kidney failure-related mortality during the first year (March 2020—February 2021) and the second year (February 2021—March 2022), whereas a notable decline in excess mortality was observed in the third year (March 2022—March 2023). Additionally, disparities in mortality were evident among various demographic groups, including age, sex, racial/ethnic subgroups, and geographic regions. Across all age subgroups, an increase in kidney failure-related mortalities was observed, with individuals aged 85 years and above experiencing the most substantial relative increase, reaching 9595.8 per million persons (95% CI: 9438.8, 9752.9). Moreover, excess kidney failure-related mortalities were recorded at 510.3 per million persons (95% CI: 502.6, 517.9) and 721.8 per million persons (95% CI: 713.4, 730.1) for women and men, respectively. Notably, non-Hispanic Blacks exhibited the highest excess mortality within the racial/ethnic group, registering at 772.6 per million persons (95% CI: 756.3, 788.9). Conclusions Our study observed high levels of excess kidney failure-related mortality during the first two years of the pandemic, followed by a notable decline in the third year. This highlights the effectiveness of current policies and prevention measures implemented to mitigate the impact of the pandemic.https://doi.org/10.1186/s12889-025-21422-2COVID-19Excess mortalityKidney failureTemporal pattern |
| spellingShingle | Zhenhu Chen Pingping Jia Di Xie Jingyu Xie Juan Liu Wangnan Cao Lefei Han Jinjun Ran Shengzhi Sun Shi Zhao Yang Ge Leonardo Martinez Xin Chen Peihua Cao Kidney failure-related excess mortality during the first three years of the COVID-19 pandemic in the United States: a nation-wide, population-based analysis BMC Public Health COVID-19 Excess mortality Kidney failure Temporal pattern |
| title | Kidney failure-related excess mortality during the first three years of the COVID-19 pandemic in the United States: a nation-wide, population-based analysis |
| title_full | Kidney failure-related excess mortality during the first three years of the COVID-19 pandemic in the United States: a nation-wide, population-based analysis |
| title_fullStr | Kidney failure-related excess mortality during the first three years of the COVID-19 pandemic in the United States: a nation-wide, population-based analysis |
| title_full_unstemmed | Kidney failure-related excess mortality during the first three years of the COVID-19 pandemic in the United States: a nation-wide, population-based analysis |
| title_short | Kidney failure-related excess mortality during the first three years of the COVID-19 pandemic in the United States: a nation-wide, population-based analysis |
| title_sort | kidney failure related excess mortality during the first three years of the covid 19 pandemic in the united states a nation wide population based analysis |
| topic | COVID-19 Excess mortality Kidney failure Temporal pattern |
| url | https://doi.org/10.1186/s12889-025-21422-2 |
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