Chronic kidney disease and respiratory failure mortality among U.S. adults ≥65 years increased from 7.0 to 34.1 per 100,000 between 1999 and 2024 (APC 7.6; 95% CI 6.67-10.42).
Observational (n=242,282)
Yes
Mortality rates from CKD and respiratory failure in older U.S. adults rose sharply from 1999 to 2021, highlighting significant demographic and regional disparities that require targeted public health interventions.
Effect estimate: APC 7.6 (95% CI 6.67-10.42)
Abstract Rationale Chronic kidney disease (CKD) and respiratory failure (RF) are major contributors to morbidity and mortality among older adults in the United States. Even while medical care has gotten better, we still don’t fully understand how these illnesses affect death rates. Monitoring temporal patterns and demographic disparities in CKD- and RF-related mortality is crucial for identifying high-risk populations and guiding resource allocation. This study utilized nationally representative data to evaluate 25-year trends in mortality linked to chronic renal disease and respiratory failure among U.S. people aged 65 years and older, categorized by sex, race/ethnicity, area, and level of urbanization. Methods We used information from the CDC WONDER Multiple Cause of Death database from 1999 to 2024 to perform a retrospective, population-based analysis. Those over 65 who had RF and CKD as underlying or contributing causes of death were included. The U.S. 2000 standard population was used to calculate annual age-adjusted mortality rates (AAMRs) per 100,000 population. Through Joinpoint regression we estimated the average annual percent change (AAPC) to assess temporal trends. Further, subgroup analysis were conducted by U.S census region, sex, race/ethnicity, and urbanization category. Results Among adults 65 and older, Chronic Kidney Disease(CKD) and Respiratory Failure(RF) were responsible for 242,282 deaths between 1999 and 2024. Medical facilities accounted for the majority of deaths (71.6%),followed by nursing homes (11.8%) and private homes (10.0%). From 1999-2024, the national AAMR went up from 7.0 to 34.1 (APC: 7.6; 95% CI: 6.67-10.42). It reduced from 2021 to 2024 (APC: −3.4; 95% CI: −15.48-6.30). Males consistently had a higher overall AAMR (26.0) than females (15.8). Non-Hispanic (NH) Black individuals had the highest AAMR (31.1), followed by Hispanic/Latino individuals (21.5),NH Other individuals (18.7),and NH White individuals (15.1). The West (22.3) and South (19.8) had the highest regional AAMRs, while the Northeast (18.2) had the lowest. California had the highest state-level AAMR (26.0), while Alaska had the lowest (10.4). The AAMRs of metropolitan areas were marginally higher than those of nonmetropolitan areas (17.15 vs. 16.32) Conclusion The mortality rates from CKD and RF in older U.S. adults rose sharply between 1999 and 2021 before leveling off. Geographical, racial, and sex disparities persisted, with the burden being disproportionately borne by males, New Hampshire Blacks, and residents of western and southern states. These findings demonstrate the need for targeted public health programs to reduce regional and racial inequities and improve the outcomes of care for older adults with respiratory and chronic kidney diseases. This abstract is funded by: Not Applicable
Sherwani et al. (2026) conducted an observational in Chronic kidney disease and respiratory failure (n=242,282). Chronic kidney disease and respiratory failure mortality among U.S. adults ≥65 years increased from 7.0 to 34.1 per 100,000 between 1999 and 2024 (APC 7.6; 95% CI 6.67-10.42).
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