Abstract WP136: Demographic variances and trends in mortality due to Stroke among Chronic Kidney Disease patients in the United States: a 1999–2020 Retrospective analysis

Introduction: The correlation between Stroke and chronic kidney disease (CKD) is well-documented in the existing literature. According to a meta-analysis of over two million individuals, Stroke risk increased by 7% with every 10 mL/min/1.73 m(2) decrease in GFR. Currently, there is an evident scarcity of literature aiming at the mortality trends solely due to Stroke among CKD patients across different stratified groups. Method: We examined the CDC Wonder database from 1999 to 2020 and assessed mortality rates due to Stroke (UCD-ICD-10 code: I60-69) among CKD patients (MCD-ICD-10 code: N18). We extracted Age-adjusted mortality rates (AAMR) and analyzed trends in AAMR by calculating annual percentage change (APC) and average annual percent change (AAPC) using Joinpoint. The parametric method was used to estimate 95% confidence intervals. Results: Between 1999-2020, a total of 46,568 deaths due to Stroke among CKD patients were recorded in the US. Overall, AAMR decreased from 0.822 in 1999 to 0.654 in 2020, with an AAPC of -1.3802 (p-value: 0.103268); males had a higher overall AAMR compared to females (0.755 vs. 0.557). Non-Hispanic (NH) Blacks experienced the highest AAMR (1.607), followed by NH Asians (0.713), Hispanics (0.695) and NH Whites (0.489). Notably, Hispanics observed a significant rise in mortality from 2015 to 2020 (APC: 14.2568*, p-value: 0.000058). Geographically, the West region had the highest mortality rates (0.705), followed by the South (0.682) and the Midwest (0.64). States with the highest AAMR include South Carolina (0.997), Columbia (0.98) and North Dakota (0.942), and those with the lowest AAMR include Arizona (0.307) and New York (0.326). Non-metropolitan areas had a higher AAMR than metropolitan areas (0.664 vs. 0.626). The Majority of deaths occurred in Medical facilities (53.6%), followed by Nursing homes (25.47%). Individuals aged 85+ had the greatest mortality rate (13.011). Conclusion: Our analysis found decreasing overall mortality trends from 1999 to 2020 due to Stroke among CKD patients, with the highest burden seen in men, NH Blacks, the West region and Non-metro areas. We also found a markedly increasing mortality trend among Hispanics from 2015 to 2020. These disparities might be largely attributed to health insurance gaps, delayed nephrology referrals, limited stroke care centers, systemic inequities and language or cultural barriers. This analysis provides critical evidence for devising targeted public health interventions.