Trends in Mortality Related to Acute Renal Failure in the U.S. from 1999 to 2020: A CDC-WONDER Retrospective Analysis

Trends in Mortality Related to Acute Renal Failure in the U.S. from 1999 to 2020: A CDC-WONDER Retrospective Analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Trends in Mortality Related to Acute Renal Failure in the U.S. from 1999 to 2020: A CDC-WONDER Retrospective Analysis Bisma Akram, Ayesha Aman, Arfa Akram, Eisha Tariq, Hammad Javed, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6186791/v2 This work is licensed under a CC BY 4.0 License Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Abstract Background Acute renal failure (ARF) indicates a sudden deterioration in renal function. This study analyzes mortality trends related to ARF in the U.S. from 1999 to 2020 to identify disparities. Methods We extracted the data from the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER). Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated for variables: year, gender, race and geographic regions. Annual percent changes (APCs) were analyzed using Joinpoint regression software. Results From 1999 to 2020, 1,174,156 deaths were reported for ARF-related fatalities in the U.S. Overall AAMR increased from 1999 (17.55, 95% CI 17.36 to 17.75) to 2010 (28.34,95% CI 28.2 to 28.6) with an APC of 4.44 (95% CI 4.17 to 4.7) followed by a decrease from 2010 to 2018 (24.51, 95% CI 24.32 to 24.71) and then an increase till 2020 (30.84,95% CI 30.62 to 31.05) with an APC of 11.85 (95% CI 7.9 to 14.87). AAMR remained higher in males (30.82) than in females (20.31). Blacks (33.68) had the highest mortality rates, while Asian/Pacific Islanders had lower (16.38). Upon stratification by geographical distribution, the highest AAMR was in the South (26.37). The highest AAMR was observed in Texas and Indiana, with mortality rates being twice as high as states at the lower end of the spectrum, including Alaska, Arizona, and Florida. Conclusion High ARF-related mortality rates warrant the need for targeted public health initiatives to address these issues and provide healthcare access that can influence ARF-related outcomes. Urology & Nephrology Acute renal failure Mortality Trends CDC-WONDER epidemiology Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Full Text Additional Declarations The authors declare no competing interests. Supplementary Files SupplementaryMaterial.docx Supplementary Material Cite Share Download PDF Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6186791","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":427036683,"identity":"a92359c3-d408-494a-b01d-f64814752018","order_by":0,"name":"Bisma Akram","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Bisma","middleName":"","lastName":"Akram","suffix":""},{"id":427036684,"identity":"19898c58-dfee-4757-b399-abbb0e72b62c","order_by":1,"name":"Ayesha Aman","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/UlEQVRIiWNgGAWjYJACZgaGGmYw6wMQs7ETp+UYWB3jDJAWZuK0MPODGTxQLl7APyP58OeCGjZp/mmHnz22+bVNno+ZgfHDxxzcWiRupKVJzzgmYyxxO83cOLfvtmEbMwOz5MxteKy5kWPGzMPGlsxwO8FMOrfnNiNQCxszLx4t8jfyP3/m+cdcP/92+jdpy57b9gS1GNzIYZDmbWNmNridYybN8ON2IkEthmeemUnz9h1jNrydUybZ23A7uY2ZsRmvX+SOJz/+zPOthlnudvo2iR9/btvOb28++OEjPu8LJCBxGNvAZAMe9UDAfwCZ9we/4lEwCkbBKBiZAACrJE1k57BGWwAAAABJRU5ErkJggg==","orcid":"","institution":"","correspondingAuthor":true,"prefix":"","firstName":"Ayesha","middleName":"","lastName":"Aman","suffix":""},{"id":427036685,"identity":"ed8dd199-ee7f-49fc-891a-b593662e5519","order_by":2,"name":"Arfa Akram","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Arfa","middleName":"","lastName":"Akram","suffix":""},{"id":427036686,"identity":"ca1c010c-37ea-4b60-b700-286271880ca6","order_by":3,"name":"Eisha Tariq","email":"","orcid":"","institution":"King Edward Medical University, Pakistan","correspondingAuthor":false,"prefix":"","firstName":"Eisha","middleName":"","lastName":"Tariq","suffix":""},{"id":427036687,"identity":"b7dd88cb-e140-4ea7-abd9-ca58d502a43e","order_by":4,"name":"Hammad Javed","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Hammad","middleName":"","lastName":"Javed","suffix":""},{"id":427036688,"identity":"3bd016e7-c194-421f-8eac-3c1666d3bf1a","order_by":5,"name":"Hammad Naveed","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Hammad","middleName":"","lastName":"Naveed","suffix":""},{"id":427036689,"identity":"27cf5fc2-a629-4e4e-8a44-217b8e4c443e","order_by":6,"name":"Aimen Hassan","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Aimen","middleName":"","lastName":"Hassan","suffix":""},{"id":427036690,"identity":"182f8f25-efe4-4f86-9e5d-4162cc04e710","order_by":7,"name":"Muhammad Hamza Gul","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Muhammad","middleName":"Hamza","lastName":"Gul","suffix":""},{"id":458070379,"identity":"ee4c7d82-636e-4465-b6f5-c2a6feda695d","order_by":8,"name":"Malik Waleed Zeb Khan","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Malik","middleName":"Waleed Zeb","lastName":"Khan","suffix":""}],"badges":[],"createdAt":"2025-03-09 05:06:36","currentVersionCode":2,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-6186791/v2","doiUrl":"https://doi.org/10.21203/rs.3.rs-6186791/v2","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":83575007,"identity":"ef92744e-9e10-4eab-854d-873bbd737f66","added_by":"auto","created_at":"2025-05-28 19:01:23","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":34797,"visible":true,"origin":"","legend":"\u003cp\u003eOverall Trends in Acute renal failure-related AAMR per 100,000 deaths in adults (\u003cu\u003e\u0026gt;\u003c/u\u003e25 years) in the United States, 1999 to 2020\u003cstrong\u003e. \u003c/strong\u003e[\u003cstrong\u003e* \u003c/strong\u003eIndicates that Annual Percent Change (APC) is significantly different from zero at α = 0.05; 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[\u003cstrong\u003e* \u003c/strong\u003eIndicates that Annual Percent Change (APC) is significantly different from zero at α = 0.05; AAMR = Age adjusted mortality rate].\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-6186791/v2/17d25815958e8afb9bc3036a.png"},{"id":83575226,"identity":"944efeef-bb48-465d-b502-d75886b0e62a","added_by":"auto","created_at":"2025-05-28 19:09:23","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":73948,"visible":true,"origin":"","legend":"\u003cp\u003eState-wise map showing states with highest and lowest mortality (arranged by state-wise age adjusted mortality rate per 100,000 deaths) in the United States, 1999 to 2020.\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-6186791/v2/29ff114af4f0af9c0fdb8034.png"},{"id":83575227,"identity":"173cf90c-07aa-4513-b626-de6cf0bbc870","added_by":"auto","created_at":"2025-05-28 19:09:23","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":103346,"visible":true,"origin":"","legend":"\u003cp\u003eRegion-stratified Trends in Acute renal failure-related AAMR per 100,000 deaths in adults (\u003cu\u003e\u0026gt;\u003c/u\u003e25 years) in the United States, 1999 to 2020. [\u003cstrong\u003e* \u003c/strong\u003eIndicates that Annual Percent Change (APC) is significantly different from zero at α = 0.05; AAMR = Age adjusted mortality rate].\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-6186791/v2/11b7270bf5bcfc6c1b6e9ef6.png"},{"id":83575515,"identity":"c9b22316-6614-4c19-9407-5423b9f405cb","added_by":"auto","created_at":"2025-05-28 19:25:25","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":679325,"visible":true,"origin":"","legend":"","description":"","filename":"Preprint.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6186791/v2_covered_c110e2d4-5155-4a0e-9f0b-1dfee88eb832.pdf"},{"id":83575005,"identity":"53b2d39a-3add-4dff-b007-2d92391f2537","added_by":"auto","created_at":"2025-05-28 19:01:23","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":43042,"visible":true,"origin":"","legend":"\u003cp\u003eSupplementary Material\u003c/p\u003e","description":"","filename":"SupplementaryMaterial.docx","url":"https://assets-eu.researchsquare.com/files/rs-6186791/v2/aa9af05ebd152012fe8a4472.docx"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"Trends in Mortality Related to Acute Renal Failure in the U.S. from 1999 to 2020: A CDC-WONDER Retrospective Analysis","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"King Edward Medical University","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Acute renal failure, Mortality Trends, CDC-WONDER, epidemiology","lastPublishedDoi":"10.21203/rs.3.rs-6186791/v2","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6186791/v2","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eAcute renal failure (ARF) indicates a sudden deterioration in renal function. This study analyzes mortality trends related to ARF in the U.S. from 1999 to 2020 to identify disparities.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eWe extracted the data from the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER). Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated for variables: year, gender, race and geographic regions. Annual percent changes (APCs) were analyzed using Joinpoint regression software.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eFrom 1999 to 2020, 1,174,156 deaths were reported for ARF-related fatalities in the U.S. Overall AAMR increased from 1999 (17.55, 95% CI 17.36 to 17.75) to 2010 (28.34,95% CI 28.2 to 28.6) with an APC of 4.44 (95% CI 4.17 to 4.7) followed by a decrease from 2010 to 2018 (24.51, 95% CI 24.32 to 24.71) and then an increase till 2020 (30.84,95% CI 30.62 to 31.05) with an APC of 11.85 (95% CI 7.9 to 14.87). AAMR remained higher in males (30.82) than in females (20.31). Blacks (33.68) had the highest mortality rates, while Asian/Pacific Islanders had lower (16.38). Upon stratification by geographical distribution, the highest AAMR was in the South (26.37). The highest AAMR was observed in Texas and Indiana, with mortality rates being twice as high as states at the lower end of the spectrum, including Alaska, Arizona, and Florida.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eHigh ARF-related mortality rates warrant the need for targeted public health initiatives to address these issues and provide healthcare access that can influence ARF-related outcomes.\u003c/p\u003e","manuscriptTitle":"Trends in Mortality Related to Acute Renal Failure in the U.S. from 1999 to 2020: A CDC-WONDER Retrospective Analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":2,"date":"2025-05-28 19:01:18","doi":"10.21203/rs.3.rs-6186791/v2","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}},{"code":1,"date":"2025-03-11 05:30:25","doi":"10.21203/rs.3.rs-6186791/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6d094e5f-f345-46d4-8c1b-149b91cfc3fd","owner":[],"postedDate":"May 28th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":45520644,"name":"Urology \u0026 Nephrology"}],"tags":[],"updatedAt":"2025-03-11T05:30:25+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-28 19:01:18","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v2","identity":"rs-6186791","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6186791","identity":"rs-6186791","version":["v2"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}