{
  "abstract": "Background Chronic kidney disease (CKD) and stroke share common risk factors and a bidirectional relationship, yet long-term mortality trends among individuals with both conditions remain inadequately characterized. This study examines national mortality trends among stroke patients with comorbid CKD in the United States from 1999 to 2023 and projects trends through 2043.Methods We analyzed death certificate data from CDC WONDER for adults (≥25 years) with both CKD (ICD-10 N18) and stroke (I64) listed as contributing or underlying causes of death (1999-2023). Age-adjusted mortality rates (AAMR per 1,000,000 population) were calculated and stratified by sex, age, race/ethnicity, census region, and urbanization. Joinpoint regression identified trends with annual percentage changes (APC). Autoregressive integrated moving average (ARIMA) models forecasted mortality through 2043.Results Overall, AAMR declined from 21.77 in 1999 to 14.84 in 2009 (APC -3.51), increased to 27.82 by 2012 (APC 17.30), declined to 11.27 by 2015 (APC -25.82*), and stabilized thereafter. Men consistently exhibited higher mortality than women (2023: 13.89 vs. 10.28). Older adults (≥65 years) bore the highest burden. Non-Hispanic Black individuals had the highest overall AAMR (44.36), followed by Hispanic/Latino (19.11), non-Hispanic Asian/Pacific Islander (17.02), and non-Hispanic White populations (13.18). The South region and non-metropolitan areas demonstrated persistently higher mortality. ARIMA forecasts suggest a gradual decline or stabilization through 2043, with burden concentrated in older adults and historically high-risk populations, though prediction intervals widen substantially over time.Conclusions CKD-associated stroke mortality has fluctuated over two decades with persistent disparities across demographic and geographic subgroups. While overall rates may decline or stabilize through 2043, targeted interventions remain necessary for high-risk populations, including older adults, non-Hispanic Black individuals, and residents of the South and non-metropolitan areas. These findings have implications for stroke systems planning and targeted risk reduction strategies.Highlights • CKD-associated stroke mortality declined from 1999-2009, increased transiently, then stabilized after 2015. • Non-Hispanic Black individuals experienced 3.4-fold higher mortality than non-Hispanic White counterparts. • Men consistently exhibited higher mortality than women throughout the 22-year study period. • Southern states and non-metropolitan areas demonstrated persistently elevated mortality rates. • ARIMA forecasts suggest gradual mortality decline through 2043 with persistent disparities. The figure depicts overall and sex stratified Stroke associated Chronic Kidney Disease related age adjusted mortality rates per 1,000,000 in the United States, 1999 to 2023. * Indicates that the annual percentage change (APC) is significantly different from zero at α = 0.05.Disclosures T. Patel: None.Abstract E-265 Figure 1",
  "authors": [
    {
      "affiliations": [
        "Trinity School of Medicine, Kingstown, Saint Vincent And The Grenadines"
      ],
      "name": "T Patel"
    }
  ],
  "title": "E-265 Epidemiology and forecasting of mortality attributable to chronic kidney disease and stroke: insights from CDC WONDER, 1999-2043",
  "uid": "c8d12b04-291d-5d35-9c43-98f6a5d6c92e"
}