Abstract: FR-PO0081
Age-Adjusted Mortality Trends in Acute Tubulointerstitial Nephritis by Gender, Race, and Census Region in the United States: A CDC-WONDER Study, 1999-2020
Session Information
- AKI: Epidemiology, Risk Factors, and Prevention
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- Khan, Muhammad Ali, Department of Nephrology and Hypertension, Mayo Clinic Arizona, Phoenix, Arizona, United States
- Abujlambo, Abdallah I.m., Al-Shifa Hospital, Gaza, Palestine, State of
- Hamdar, Hiba, Plovdiv Medical University, Plovdiv, Bulgaria
- Abu Jawdeh, Bassam G., Department of Nephrology and Hypertension, Mayo Clinic Arizona, Phoenix, Arizona, United States
Background
Acute tubulointerstitial nephritis (ATIN) is an underrecognized yet serious condition in the U.S., contributing notably to mortality, particularly in older adults. This study examines trends and disparities in age-adjusted mortality rates (AAMRs) linked to ATIN from 1999 to 2022, stratified by gender, census region, and race, aiming to identify inequities and guide targeted public health interventions.
Methods
A retrospective analysis using CDC WONDER assessed U.S. ATIN-related mortality from 1999–2020. AAMRs per 100,000 were stratified by gender, race, and region. Temporal trends were analyzed using Joinpoint Regression to estimate annual percentage changes (APCs) and corresponding 95% confidence intervals (CI).
Results
Mortality trends among adults aged ≥25 years were analyzed from 1999–2020, identifying 6,872 ATIN-related deaths. AAMRs declined for both sexes from 1999–2013, followed by a sharp rise from 2013–2020, with males showing a slightly higher increase than females (9.90% vs. 9.50%, P < 0.05). Racial disparities were observed: Black/African American individuals had a larger initial decline in AAMRs (-4.96%, P < 0.05) but a smaller later rise than White individuals (10.82%, P < 0.05). Regionally, similar patterns were seen from 1999–2013, followed by reversals. Mortality rose steeply in the Northeast (APC = 9.68%, P < 0.05) and Midwest (APC = 12.08%, P < 0.05) during 2013–2020 and 2014–2020, respectively. The South and West showed the same biphasic pattern, with initial declines and significant post-2012 increases (APC = 7.70% and 5.36%, P < 0.05).
Conclusion
This nationwide analysis highlights a concerning reversal in ATIN-related mortality trends among U.S. adults over the past two decades. These findings highlight a significant shift in ATIN-related mortality patterns in the U.S., suggesting the need for further investigation into healthcare access, environmental exposures, and socio-economic factors.