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Abstract: FR-PO0340

Trends and Disparities in Cardiovascular Mortality in Patients with Diabetic Kidney Disease in the United States, 1999-2020

Session Information

Category: Diabetic Kidney Disease

  • 702 Diabetic Kidney Disease: Clinical

Authors

  • Gandhi, Dhruv, St Francis Medical Center, Monroe, Louisiana, United States
  • Ahmad, Wajdan, Al Tibri Medical College, Karachi, Sindh, Pakistan
  • Sawale, Mihika, K J Somaiya Medical College and Research Centre, Mumbai, MH, India
  • Maniar, Romil Hemal, St Agnes Ascension, Baltimore, Maryland, United States
  • Deshmukh, Indraneel Abhijit, The University of Texas Health Science Center at Houston, Houston, Texas, United States
  • Bendre, Adwait Suhas, K J Somaiya Medical College and Research Centre, Mumbai, MH, India
Background

The aim of this study is to determine trends and disparities in cardiovascular mortality of type 2 diabetic kidney disease patients older than 45 years of age from 1999-2020.

Methods

Retrospective analysis of Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database was performed. Age-adjusted mortality rates (AAMR) and crude death rates (CDR) per 100,000 persons were determined. Average annual percentage change (AAPC) was determined using Joinpoint regression. Temporal trends were analyzed in sex, race, geographical distribution and patient age-related mortality.

Results

41,936 deaths in type 2 diabetic kidney disease patients from cardiovascular disease were reported. Overall AAMR was 1.61 (AAPC:22.28;p<0.0001). AAMRs from 1999-2014 showed a steep increase from 0.08 to 2.62 (AAPC:28.47;p<0.0001) followed by a less sharp increase till 2020 from 2.62 to 4.45 (AAPC:8.09;p=0.056). Males had a higher AAMR (2.27) than females (1.18) and both showed an increase in mortality (male AAPC:22.27 and female AAPC:22.56;p<0.0001 for both). Geographically, AAMRs were highest in West (2.55) followed by Midwest (1.79), South (1.34), and Northeast (0.94). All census regions showed an increase in AAMR, with the greatest increase seen in Midwest (AAPC:17.09;p<0.0001). Nonmetropolitan areas showed disproportionately higher mortality (AAMR:1.88) than metropolitan areas (AAMR:1.57). Metropolitan areas showed a sharp increase in AAMR (AAPC:22.95;p<0.0001). Of 10-year age group, there was a consistent increase in CDR with advancing age from 0.14 for 45-54 years to 10.5 for 85+ years. All age groups showed an overall increase in mortality between 1999-2020, with the greater increase seen for 75-84 years (AAPC:23.56;p<0.0001), followed by 65-74 years (AAPC:21.67;p<0.0001).

Conclusion

We found significant increase in cardiovascular mortality, though persistent disparities exist. Males, elderly individuals, residents of West and nonmetropolitan areas experienced disproportionately higher mortality rates.

Digital Object Identifier (DOI)