Chronic kidney disease related mortality trends with and without valvular heart disease among adults in the United States: A retrospective analysis

BACKGROUND: Chronic kidney disease (CKD) and valvular heart disease (VHD) represent a significant global public health challenge. CKD is a major, independent risk factor for the development and progression of VHD. We aimed to examine the long-term mortality trends associated with VHD in individuals with and without CKD in the United States. METHODS: We obtained death certificate data for individuals aged ≥ 25 from the CDC WONDER, identifying deaths with VHD (International Classification of Diseases, 10th Revision [ICD-10] codes I05-I08) and CKD (ICD-10 N18). We calculated age-adjusted mortality rates (AAMRs) and crude mortality rates per 100,000 people. Annual percentage changes (APCs), average APC, and average differences in APCs through Joinpoint Regression. RESULTS: From 1999 to 2023, Concurrent VHD and CKD were attributed with 71,412 fatalities. AAMR rose from 0.81 in 1999 to 1.62 in 2023, reflecting an overall AAPC of 3.22 (95% CI: 2.20-4.26; p < 0.001). Males consistently exhibited higher AAMRs compared to females, but females showed a steeper rise (AAPC: 3.31 vs. 2.94). The highest AAMR was noted among non-Hispanic (NH) Black or African American individuals with an AAPC of 1.48. Mortality rates were elevated in the Midwest and among rural demographics when contrasted with urban populations. Mortality trends for concurrent VHD and CKD surpassed those for VHD or CKD alone. CONCLUSION: Importantly, the increase in mortality associated with concurrent VHD and CKD occurred at a faster rate than that of VHD alone or CKD alone. These findings underscore the need for targeted interventions to address these disparities.