MORTALITIES DUE TO KIDNEY FAILURE IN PATIENTS WITH FIBROTIC AND CIRRHOTIC DISEASES OF THE LIVER IN THE UNITED STATES FROM 1999 TO 2020: A CDC WONDER STUDY

 

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MORTALITIES DUE TO KIDNEY FAILURE IN PATIENTS WITH FIBROTIC AND CIRRHOTIC DISEASES OF THE LIVER IN THE UNITED STATES FROM 1999 TO 2020: A CDC WONDER STUDY

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Abdulqadir
Nashwan
Iqra Shahid Iqrashahid1412@gmail.com King Edward Medical University College of Medicine Lahore Pakistan -
Hafiz Sheheryar Aamir sheharyaramir99@gmail.com King Edward Medical University College of Medicine Lahore Pakistan -
Shameer Iqbal Ghuman shameerghuman7@gmail.com King Edward Medical University College of Medicine Lahore Pakistan -
Minhal Chaudhry minhalchaudhry42@gmail.com King Edward Medical University College of Medicine Lahore Pakistan -
Abdulqadir Nashwan anashwan@hamad.qa Hamad Medical Corporation Nursing & Midwifery Research Department Doha Qatar *
Muneeb Ahsan muneebahsan1029@gmail.com Allama Iqbal Medical College College of Medicine Lahore Pakistan -
Muhammad Wali Hassan walihassanmwh@gmail.com King Edward Medical University College of Medicine Lahore Pakistan -
Zaryab Bacha zaryab03443578390@gmail.com Khyber Medical College College of Medicine Peshawar Pakistan -
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Kidney failure, most commonly due to prerenal etiology, is a serious complication of fibrotic or cirrhotic diseases of the liver increased portal pressure, which is the hallmark of cirrhosis, leads to blood pooling in the splanchnic circulation and ultimately reduced renal perfusion. This study aims to analyze the trends in mortality associated with kidney failure in patients with fibrotic and cirrhotic liver diseases in the United States from 1999 to 2020.

We used death certificates from the CDC Wonder database to calculate age-adjusted mortality rates (AAMR) and crude mortality rate (CMR) per 100,000 persons from 1999 to 2020. AAMRs were stratified by year, gender, race, age groups and geographical distribution. Annual percentage changes (APC) in AAMR with 95% CI were obtained using Joinpoint Regression Analysis. 

A total of 114,495 kidney failure and fibrotic or cirrhotic liver disease-associated deaths were recorded between 1999 and 2020. The AAMR increased from 1.37 in 1999 to 1.6 in 2018 [APC (1999-2018)=0.37, 95% CI=-0.13 to 0.88, p=0.134] after which it increased again to 1.84 in 2020 [APC (2018-2020)=8.31, 95% CI=-6.39 to 25.3, p=0.27]. The AAMR remained higher in Men (overall AAMR: 2.02) than women (overall AAMR: 1.13) throughout the study period. NH American have the highest overall AAMR (2.75) followed by NH Black (1.78), NH White (1.51) and Asian or Pacific Islanders (1.09). AAMR also varied by region. The South exhibited the highest overall AAMR (1.72) followed by West (1.55), Midwest (1.4) and Northeast (1.32). Upon stratification by urbanization, AAMR was the highest in Medium Metropolitans (1.67) followed by Large Central Metropolitans (1.61), Small Metropolitan (1.56), Micropolitans (1.55), Noncore (1.54) and Large Fringe Metropolitans (1.33).

An overall increase in mortality related to kidney failure and fibrotic or cirrhotic liver diseases has been observed in the United States from 1999-2020. The highest mortality rates were found in male individuals, individuals belonging to NH Black ethnicity and in Medium Metropolitans in the Southern region. Targeted interventions, including systemic reforms in healthcare practices, must be initiated to combat such variations in mortality.

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