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Background <p>Atrial fibrillation (AF) and acute renal failure (ARF) frequently coexist, creating a bidirectional pathophysiologic interaction that amplifies morbidity and mortality risks. Despite their clinical significance, nationwide trends in AF-associated mortality among patients with ARF remain underexplored in the United States.</p> Methods <p>Using mortality data from the CDC WONDER database (1999–2024), we conducted a retrospective analysis of deaths among adults aged 25&#xa0;years and older with AF (ICD-10: I48) and ARF (ICD-10: N17). Age-adjusted mortality rates (AAMRs) were calculated per 100,000 population using the 2000 U.S. standard population. Temporal trends and annual percent changes (APCs) were assessed using Joinpoint regression analysis.</p> Results <p>From 1999 to 2024, 139,956 AF–ARF–associated deaths were recorded. AAMRs increased from 0.6 (95% CI 0.6–0.7) in 1999 to 5.0 (95% CI 4.9–5.1) in 2024, peaking during 2019–2022 (APC: + 34.55, <i>p</i> &lt; 0.000001), followed by a significant decline (APC: –&#xa0;8.55, <i>p</i> = 0.0036). Mortality remained consistently higher in men than women and was greatest among non-Hispanic Whites and American Indians/Alaska Natives. The South and nonmetropolitan regions exhibited the highest regional mortality burdens. State-level disparities showed particularly elevated rates in Kentucky, South Carolina, and Washington.</p> Conclusions <p>AF-associated mortality among individuals with ARF has risen dramatically over two decades, with a recent partial decline. Persistent sex, racial, and geographic disparities underscore the need for targeted prevention, early identification, and integrated cardio-renal management strategies to mitigate mortality in this high-risk population.</p>

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Temporal trends in mortality attributable to atrial fibrillation among adults with acute renal failure in the United States, 1999–2024

  • 期刊论文

  • 发表日期：

    2025年11月21日

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  • Laksh Kumar,
  • Iqra Mustafa,
  • Neeraj Kumar,
  • Abdul Fasih,
  • Syeda Warisha,
  • Laiba Khan,
  • Laiba Khurram,
  • F. N. U. Taneer,
  • Abdul Basit,
  • Usba Rafique,
  • Sumet Kumar,
  • Sumeet Kumar,
  • Subhash Chandar,
  • Adarsh Raja

摘要

Background

Atrial fibrillation (AF) and acute renal failure (ARF) frequently coexist, creating a bidirectional pathophysiologic interaction that amplifies morbidity and mortality risks. Despite their clinical significance, nationwide trends in AF-associated mortality among patients with ARF remain underexplored in the United States.

Methods

Using mortality data from the CDC WONDER database (1999–2024), we conducted a retrospective analysis of deaths among adults aged 25 years and older with AF (ICD-10: I48) and ARF (ICD-10: N17). Age-adjusted mortality rates (AAMRs) were calculated per 100,000 population using the 2000 U.S. standard population. Temporal trends and annual percent changes (APCs) were assessed using Joinpoint regression analysis.

Results

From 1999 to 2024, 139,956 AF–ARF–associated deaths were recorded. AAMRs increased from 0.6 (95% CI 0.6–0.7) in 1999 to 5.0 (95% CI 4.9–5.1) in 2024, peaking during 2019–2022 (APC: + 34.55, p < 0.000001), followed by a significant decline (APC: – 8.55, p = 0.0036). Mortality remained consistently higher in men than women and was greatest among non-Hispanic Whites and American Indians/Alaska Natives. The South and nonmetropolitan regions exhibited the highest regional mortality burdens. State-level disparities showed particularly elevated rates in Kentucky, South Carolina, and Washington.

Conclusions

AF-associated mortality among individuals with ARF has risen dramatically over two decades, with a recent partial decline. Persistent sex, racial, and geographic disparities underscore the need for targeted prevention, early identification, and integrated cardio-renal management strategies to mitigate mortality in this high-risk population.