Abstract: TH-OR051
Substance Use Disorder-Associated Kidney Failure Deaths in the United States, 1999-2024: A 25-Year Population-Level Analysis
Session Information
- CKD Outcomes: Novel Biomarkers, Interventions, and Multiorgan Crosstalk
October 22, 2026 | Location: Mile High Ballroom 1D, Convention Center
Abstract Time: 05:20 PM - 05:30 PM
Category: CKD (Non-Dialysis)
- 2201 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Kodali, Naga Anvesh, University of Central Florida/HCA Florida Ocala Hospital, Ocala, Florida, United States
- Seth, Sukriti, University of Central Florida/HCA Florida Ocala Hospital, Ocala, Florida, United States
- Desai, Hardik, AB Plus Multispecialty Hospital, Ahmedabad, Florida, United States
- Nwakoby, Izuchukwu E., University of Central Florida/HCA Florida Ocala Hospital, Ocala, Florida, United States
Background
Renal failure and substance use disorder (SUD) are each escalating, yet their lethal convergence at population scale is poorly characterized. We provide the first national portrait of renal failure deaths in which psychoactive substance use is documented as a contributing cause across a quarter-century in the United States.
Methods
From CDC WONDER Multiple Cause-of-Death files (1999–2020 bridged-race; 2018–2024 single-race), we identified decedents with ICD-10 N17–N19 (renal failure) as underlying cause and F10–F19 (psychoactive substance use disorders) coded as contributing cause. Age-adjusted mortality rates (AAMR) per 100,000 used the year-2000 U.S. standard. Annualized percentage change (APC) with 95% CIs was derived from log-linear regression of annual counts/rates on calendar year, stratified by sex, age, census region, urbanization, race, Hispanic origin, and place of death.
Results
45,273 deaths met criteria over 1999–2024; annual counts rose 14.1-fold (186 to 2,615; peak 2,875 in 2022) and AAMR climbed from 0.1 to 0.7. Overall APC was +11.34% (95%CI 8.47–14.29) for counts and +8.18% (5.60–10.83) for AAMR. Burden was disproportionately male (64.6%) yet the rise was steeper in women (APC +12.26% vs +10.93%). Adults aged 55–84 carried the largest absolute burden, with the sharpest relative climb in those ≥85 years (APC +13.13%). The Midwest led regionally (APC +13.39%), and Large Fringe and Small Metros outpaced Large Central Metros. Inpatient hospitals accounted for 55.0% of deaths, but home deaths rose fastest (APC +15.37%). State-level trajectories diverged from −1.44% (New Jersey) to +11.77% (North Carolina).
Conclusion
Renal failure deaths with co-existing SUD have multiplied fourteen-fold over 25 years, with widening sex parity, geographic heterogeneity, and migration of dying out of acute-care settings signaling urgent need for integrated nephrology–addiction care pathways.