Trends in chronic kidney disease mortality among patients with systemic lupus erythematosus: a U.S. population-based study (1999–2020)

Abstract Background Despite advancements in treatment, chronic kidney disease (CKD) remains a major cause of morbidity and mortality in systemic lupus erythematosus (SLE). However, a comprehensive analysis of mortality trends and demographic disparities remains limited. This study aims to evaluate mortality related to CKD among patients diagnosed with SLE, acknowledging that the specific cause of CKD (e.g., lupus nephritis vs. other etiologies) cannot be determined from available data. Methods The CDC WONDER database was used to obtain mortality data for US patients due to chronic renal failure in SLE from 1999 to 2020. Crude and age-adjusted mortality rates (AAMRs) per 100,000 individuals were calculated and stratified by gender, race, year, state, census region, urbanization, and place of death. Trends in AAMRs were evaluated using Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC). Results Between 1999 and 2020, a total of 5204 deaths were attributed to chronic renal failure in patients with SLE. The overall AAMR for CKD in SLE patients increased from 0.076 to 0.104 during this period, with a pronounced rise from 2018 to 2020 (APC: 15.06). Females exhibited higher AAMR than males (0.116 vs. 0.013). Additionally, AAMRs were highest among non-Hispanic (NH) African Americans and lowest among NH Whites (0.265 vs. 0.036). Regionally, the highest AAMRs were recorded in the West, South Carolina, and Metropolitan areas. The highest crude death rate (CDR) was observed in the 55–85 + age group. Conclusions Mortality from CKD among patients with SLE has risen over the past two decades, especially from 2018 to 2020. These discrepancies underscore the need for targeted healthcare strategies and legislative measures to reduce the growing mortality burden.