Trends in chronic lymphocytic leukemia mortality among older adults with renal failure in the United States: A 25-year retrospective study.

Abstract Background: Renal failure is a frequent comorbidity in patients with chronic lymphocytic leukemia (CLL), contributing to poor outcomes and limited treatment options. This study evaluates national mortality trends in older adults with CLL and coexisting renal failure. Methods: Using the CDC WONDER Multiple Cause of Death database (1999–2024), we identified adults aged ≥65 years with CLL listed as the underlying cause of death and renal failure as a contributing cause. Age-adjusted mortality rates (AAMRs) per 100,000 U.S. population were calculated. Joinpoint regression was applied to assess temporal trends using annual percent change (APC). Results: A total of 8,213 deaths were recorded. The AAMR showed a modest rise from 0.6 in 1999 to 0.7 in 2024. A significant increase was observed from 1999 to 2004 (APC: +6.76%), followed by a gradual decline thereafter (APC: -0.21%). Males (1.2) had an AAMR three times higher than females (0.4). Non-Hispanic Whites (0.8) experienced the greatest burden across racial/ethnic groups. AAMRs were higher in non-metropolitan areas (0.8) and the Midwest region (0.8), indicating regional and rural disparities. Conclusions: While CLL mortality in the context of renal failure initially increased, the overall trend has stabilized in recent decades. Nonetheless, disparities by sex, geography, and race persist. These findings emphasize the need for targeted interventions to address renal complications in CLL and improve outcomes in high-risk populations.