The age-adjusted mortality rate for deaths documenting both AF/flutter and renal failure increased markedly among U.S. adults aged ≥45 years between 1999 and 2023, with differences by sex, race/ethnicity, and geographic location.
The study identified 392,927 death certificates among U.S. adults aged ≥45 years from 1999 to 2023 that recorded both atrial fibrillation/flutter and renal failure.
The age-adjusted mortality rate for deaths documenting both conditions rose from 6.3 per 100,000 in 1999 to 20.6 per 100,000 in 2023.
Joinpoint regression showed significant upward trends in two periods, with a steeper increase in the later period.
Age-adjusted mortality rates were higher among men than women throughout the study period.
In 2023, age-adjusted mortality rates differed substantially across race/ethnicity groups, highest in non-Hispanic White individuals and lowest in non-Hispanic Asian or Pacific Islander individuals.
The magnitude of mortality involving both conditions varied by geographic location.
The findings reflect population-level co-documentation of the two conditions on death certificates and do not establish causation of death.
This study looked at U.S. death certificates from 1999 to 2023 for adults aged 45 and older to see how often both atrial fibrillation or flutter (an irregular heart rhythm) and kidney failure were listed together. Nearly 393,000 death certificates mentioned both conditions. After adjusting for age, the rate of such deaths rose from 6.3 to 20.6 per 100,000 people, about a threefold increase. The rise was significant in two periods, 1999 to 2012 and 2015 to 2023, and it was faster in the later period. Rates were consistently higher in men than in women. In 2023, rates were highest among non-Hispanic White individuals (22.55 per 100,000) and non-Hispanic Black individuals (19.91), and lower among American Indian or Alaska Native (14.31), Hispanic (11.75), and Asian or Pacific Islander (10.28) individuals. The authors also report differences by geographic location. These figures reflect how often the two conditions were written on death certificates together, not proof that either condition or their combination caused death. Changes in diagnosis, recording practices, or population health could also play a role. This research suggests the combination of heart rhythm problems and kidney failure is increasingly documented at death, and the authors call for studies of individual patients to understand the clinical and healthcare factors behind the trends.
Faheem M, Hassan S, Nawaz H, Asghar T, Shadab S, Khan M, et al.. (2026). Trends in mortality involving atrial fibrillation/flutter and renal failure in the United States, 1999-2023: A nationwide multiple-cause-of-death analysis.. Medicine. https://doi.org/10.1097/MD.0000000000051249