Trends and disparities in heart failure mortality with and without chronic kidney disease in a nationwide retrospective analysis

Abstract Chronic kidney disease (CKD) is a significant global contributor to morbidity and mortality, with many CKD patients developing heart failure (HF), leading to worsened outcomes. However, limited research has examined temporal trends and disparities in patients with concurrent HF and CKD. Usi...

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Main Authors: Maryam Shahzad, Sophia Ahmed, Muneeba Ahsan, Eeshal Zulfiqar, Sonia Hurjkaliani, Tanya Thakur, Rozi Khan, Pooja Sethi, Mohamed Daoud, Aman Goyal
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-04056-7
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author Maryam Shahzad
Sophia Ahmed
Muneeba Ahsan
Eeshal Zulfiqar
Sonia Hurjkaliani
Tanya Thakur
Rozi Khan
Pooja Sethi
Mohamed Daoud
Aman Goyal
author_facet Maryam Shahzad
Sophia Ahmed
Muneeba Ahsan
Eeshal Zulfiqar
Sonia Hurjkaliani
Tanya Thakur
Rozi Khan
Pooja Sethi
Mohamed Daoud
Aman Goyal
author_sort Maryam Shahzad
collection DOAJ
description Abstract Chronic kidney disease (CKD) is a significant global contributor to morbidity and mortality, with many CKD patients developing heart failure (HF), leading to worsened outcomes. However, limited research has examined temporal trends and disparities in patients with concurrent HF and CKD. Using the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database, we analyzed concurrent HF and CKD-related deaths among adults aged ≥ 25 years. Mortality rates were stratified by age, sex, race/ethnicity, urbanization, and region. Age-adjusted mortality rates (AAMRs) and crude mortality rates (CMRs) per 100,000 were calculated. Trends were assessed using annual percentage changes (APCs) and average APC differences via Joinpoint Regression software. Statistical significance was defined as p < 0.05. From 1999 to 2020, the AAMR increased from 6.74 in 1999 to 8.88 in 2005 (APC 3.90%, 95% CI: 2.83–5.07, p < 0.001), declined to 7.18 in 2010 (APC − 4.15%, 95% CI: -5.78 to -3.03, p < 0.001), then rose sharply to 14.78 in 2020 (APC 7.46%, 95% CI: 7.05–7.87, p < 0.001). Males exhibited a higher AAMR (13.46) than females (7.9). Non-Hispanic (NH) Black individuals had the highest AAMR (15.05). Mortality was highest in the Midwest (AAMR 11.77) and among rural populations (AAMR 11.77) compared to urban residents. Mortality trends for concurrent HF and CKD surpassed those for HF or CKD alone. Concurrent HF and CKD-related mortality has increased across all demographic groups, with the highest risks observed in men, NH Black individuals, and rural populations. These findings underscore the need for targeted interventions to address these disparities.
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spelling doaj-art-eec14b4c3cfd478b93363929aa6969742025-08-20T03:04:25ZengNature PortfolioScientific Reports2045-23222025-08-0115111510.1038/s41598-025-04056-7Trends and disparities in heart failure mortality with and without chronic kidney disease in a nationwide retrospective analysisMaryam Shahzad0Sophia Ahmed1Muneeba Ahsan2Eeshal Zulfiqar3Sonia Hurjkaliani4Tanya Thakur5Rozi Khan6Pooja Sethi7Mohamed Daoud8Aman Goyal9Department of Internal Medicine, Dow University of Health SciencesDepartment of Internal Medicine, Allama Iqbal Medical CollegeDepartment of Internal Medicine, Dow University of Health SciencesDepartment of Internal Medicine, Dow University of Health SciencesDepartment of Internal Medicine, Dow University of Health SciencesDepartment of Internal Medicine, Government Medical CollegeDepartment of Internal Medicine, UPMC HarrisburgDepartment of Cardiovascular Medicine, Texas Tech University Health Sciences CenterDepartment of Internal Medicine, Bogomolets National Medical UniversityDepartment of Internal Medicine, Cleveland Clinic FoundationAbstract Chronic kidney disease (CKD) is a significant global contributor to morbidity and mortality, with many CKD patients developing heart failure (HF), leading to worsened outcomes. However, limited research has examined temporal trends and disparities in patients with concurrent HF and CKD. Using the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database, we analyzed concurrent HF and CKD-related deaths among adults aged ≥ 25 years. Mortality rates were stratified by age, sex, race/ethnicity, urbanization, and region. Age-adjusted mortality rates (AAMRs) and crude mortality rates (CMRs) per 100,000 were calculated. Trends were assessed using annual percentage changes (APCs) and average APC differences via Joinpoint Regression software. Statistical significance was defined as p < 0.05. From 1999 to 2020, the AAMR increased from 6.74 in 1999 to 8.88 in 2005 (APC 3.90%, 95% CI: 2.83–5.07, p < 0.001), declined to 7.18 in 2010 (APC − 4.15%, 95% CI: -5.78 to -3.03, p < 0.001), then rose sharply to 14.78 in 2020 (APC 7.46%, 95% CI: 7.05–7.87, p < 0.001). Males exhibited a higher AAMR (13.46) than females (7.9). Non-Hispanic (NH) Black individuals had the highest AAMR (15.05). Mortality was highest in the Midwest (AAMR 11.77) and among rural populations (AAMR 11.77) compared to urban residents. Mortality trends for concurrent HF and CKD surpassed those for HF or CKD alone. Concurrent HF and CKD-related mortality has increased across all demographic groups, with the highest risks observed in men, NH Black individuals, and rural populations. These findings underscore the need for targeted interventions to address these disparities.https://doi.org/10.1038/s41598-025-04056-7EpidemiologyPublic healthChronic kidney diseaseHeart failureUnited StatesMortality trends.
spellingShingle Maryam Shahzad
Sophia Ahmed
Muneeba Ahsan
Eeshal Zulfiqar
Sonia Hurjkaliani
Tanya Thakur
Rozi Khan
Pooja Sethi
Mohamed Daoud
Aman Goyal
Trends and disparities in heart failure mortality with and without chronic kidney disease in a nationwide retrospective analysis
Scientific Reports
Epidemiology
Public health
Chronic kidney disease
Heart failure
United States
Mortality trends.
title Trends and disparities in heart failure mortality with and without chronic kidney disease in a nationwide retrospective analysis
title_full Trends and disparities in heart failure mortality with and without chronic kidney disease in a nationwide retrospective analysis
title_fullStr Trends and disparities in heart failure mortality with and without chronic kidney disease in a nationwide retrospective analysis
title_full_unstemmed Trends and disparities in heart failure mortality with and without chronic kidney disease in a nationwide retrospective analysis
title_short Trends and disparities in heart failure mortality with and without chronic kidney disease in a nationwide retrospective analysis
title_sort trends and disparities in heart failure mortality with and without chronic kidney disease in a nationwide retrospective analysis
topic Epidemiology
Public health
Chronic kidney disease
Heart failure
United States
Mortality trends.
url https://doi.org/10.1038/s41598-025-04056-7
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