Kidney Week

Abstract: SA-PO0383

Sex-Specific Trends in Mortality Among Patients with CKD and Peripheral Vascular Disease in the United States, 1999-2024: A Joinpoint Analysis

Session Information

• CKM: Clinical - Epidemiology and Outcomes
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Cardiovascular-Kidney-Metabolic Health

• 602 Cardiovascular-Kidney-Metabolic Health: Clinical

Authors

• Ejeagha, Franklin Chinezimuzo, New York Medical College St Mary's General Hospital and St Clare's Health, Denville, New Jersey, United States

Franklin Chinezimuzo Ejeagha, MBBS

• Shah, Hriday, New York Medical College St Mary's General Hospital and St Clare's Health, Denville, New Jersey, United States

Hriday Shah, MD

• Onyebuchukwu, Chiamaka Queenet, SUNY Downstate Health Sciences University, New York, New York, United States

Chiamaka Queenet Onyebuchukwu, MBBS

• Ozumba, Sara O., Cape Fear Valley Health System, Fayetteville, North Carolina, United States

Sara O. Ozumba, MBBS

• Prasad Mylarappa, Yashas, New York Medical College St Mary's General Hospital and St Clare's Health, Denville, New Jersey, United States

Yashas Prasad Mylarappa, MD

• Raghavan, Shraddha, New York Medical College St Mary's General Hospital and St Clare's Health, Denville, New Jersey, United States

Shraddha Raghavan, MD

Background

Peripheral vascular disease (PVD) is highly prevalent in chronic kidney disease (CKD), affecting 25% of patients with CKD, with markedly higher mortality risk when both co-exist.

Although females have a cardiovascular survival advantage over males, evidence suggests that CKD diminishes this protection. Concurrently, sex based disparities in PVD are increasingly apparent, suggesting differing sex-specific mortality trajectories in patients with both conditions.

We examined U.S. mortality data from 1999 to 2024 to describe temporal patterns in deaths involving PVD with CKD, stratified by sex.

Methods

Mortality data of patients with CKD and PVD were obtained from the U.S. Multiple Cause of Death database for the years 1999–2024. Age-adjusted mortality rates (per 100,000 population) were calculated using the 2000 U.S. standard population. Joinpoint regression analysis, performed with the National Cancer Institute Joinpoint Regression Program, was used to evaluate temporal trends and identify changes in mortality patterns. Annual percent change (APC) was calculated for each segment with 95% confidence interval, and significance was defined as p<0.05. Analyses were stratified by sex.

Results

From 1999 to 2024, mortality rates involving CKD with PVD showed similar early trends in both males and females with an initial decline through 2009, a pronounced rise from 2009 to 2012, and divergent patterns after 2015. Mortality rates were consistently higher in males throughout the study period. In 1999, the male-to-female mortality rate ratio was 1.86, and males continued to experience mortality rates approximately 1.6–2 times higher than females across much of the study period. Joinpoint-derived APC estimates are shown in Figure 1.

Conclusion

Mortality rate in patients with co-existing CKD and PVD from 1999-2024 in the United States was found to be consistently higher in males, emphasizing the need for integrated cardio-renal prevention strategies and targeted interventions to reduce sex based disparities.

Figure 1