Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Nephrol. Jun 25, 2025; 14(2): 105815
Published online Jun 25, 2025. doi: 10.5527/wjn.v14.i2.105815
Epidemiological trends in diabetic renal complications in United States adults: A center for disease control and prevention wide-ranging online data for epidemiologic research analysis (1999-2020)
Abdullah Naveed Muhammad, Faizan Ahmed, Sherif Eltawansy, Ahila Ali, Bazil Azeem, Muhammad Kashan, Zaima Afzaal, Mushood Ahmed, Kainat Aman, Aman Amanullah, Muhammad Naveed Uz Zafar, Pawel Lajczak, Ogechukwu Obi
Abdullah Naveed Muhammad, Muhammad Kashan, Department of Internal Medicine, Dow Medical College, Karachi 74200, Sindh, Pakistan
Faizan Ahmed, Department of Cardiology, Duke University Hospital, Durham, NC 27710, United States
Sherif Eltawansy, Department of Internal Medicine, Jersey Shore University Medical Center, Neptune, NJ 07753, United States
Ahila Ali, Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi 74900, Sindh, Pakistan
Bazil Azeem, Department of Medicine, Shaheed Mohtarma Benazir Bhutto Medical College Liyari, Karachi 74900, Pakistan
Zaima Afzaal, Department of Internal Medicine, Services Institute of Medical Sciences, Lahore 54000, Punjab, Pakistan
Mushood Ahmed, Department of Internal Medicine, Rawalpindi Medical University, Rawalpindi 74200, Pakistan
Kainat Aman, Department of Internal Medicine, Batterjee Medial College, Jeddah 21442, Saudi Arabia
Aman Amanullah, Department of Internal Medicine, SSM Health St Louis University, St Louis, MO 63104, United States
Muhammad Naveed Uz Zafar, Department of Internal Medicine, Liaquat Institute of Medical and Health Sciences, Thatta 73130, Sindh, Pakistan
Pawel Lajczak, Department of Biophysics, Medical University of Silesia in Katowice, Katowice 40-055, Poland
Ogechukwu Obi, Department of Internal Medicine, New York Institute of Technology, College of Osteopathic Medicine, Westbury, NY 11568, United States
Author contributions: Muhammad AN and Eltawansy S contributed to methodology; Ali A contributed to software; Azeem B and Kashan M contributed to validation; Afzaal Z and Ahmed M contributed to formal analysis; Aman K and Amanullah A contributed to investigation; Naveed Uz Zafar M contributed to data curation; Lajczak P and Obi O contributed to the writing of the original draft.
Institutional review board statement: Researchers are not required to obtain explicit consent from participants as a national database was used with deidentified patient information.
Informed consent statement: Informed consent was waived due to using a national database.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest related to this work.
Data sharing statement: Data available within the article or its Supplementary materials. The authors confirm that the data supporting the findings of this study are available within the article and its Supplementary materials.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sherif Eltawansy, Assistant Professor, Department of Internal Medicine, Jersey Shore University Medical Center, Neptune, NJ 07753, United States. alanine40@hotmail.com
Received: February 8, 2025
Revised: March 5, 2025
Accepted: March 21, 2025
Published online: June 25, 2025
Processing time: 61 Days and 7.5 Hours
Abstract
BACKGROUND

Renal complications of diabetes mellitus pose a significant public health challenge, contributing to substantial morbidity and mortality globally. Understanding temporal trends and regional disparities in mortality related to diabetic nephropathy is crucial for guiding targeted interventions and policy decisions.

AIM

To display the trends and disparities of diabetic nephropathy related mortality.

METHODS

A retrospective analysis was conducted using death certificate data from the center for disease control and prevention (CDC) wide-ranging online data for epidemiologic research analysis (WONDER) database, spanning from 1999 to 2020, to investigate mortality related to renal complications of diabetes in adults aged 35 or above. Age-adjusted mortality rate (AAMR) per 100000 persons and annual percent change (APC) were computed, with stratification by year, sex, race/ethnicity, and geographic region.

RESULTS

Between 1999 and 2020, a total of 525804 deaths occurred among adults aged 35 to 85+ years due to renal-related issues associated with diabetes. AAMR for renal-related deaths in adult diabetic patients showed a consistent increase from 1.6 in 1999 to 34.9 in 2020 (average APC [AAPC]: 17.23; 95% confidence interval [CI]: 13.35-28.79). Throughout the study period, men consistently had higher AAMR (overall AAMR for men: 17.8; 95%CI: 17.7-17.9). In 1999, the AAMR for men was 1.8, increasing to 44.2 by 2020 (AAPC: 17.54; 95%CI: 13.09-29.53), while for women, it was 1.6 in 1999 and rose to 27.6 by 2020 (AAPC: 15.55; 95%CI: 13.35-21.10). American Indian/Alaska Native adults exhibited the highest overall AAMR (36.1; 95%CI: 35.2-36.9), followed by Black/African American (25.5; 95%CI: 25.3-25.7). The highest mortality was observed in the Western (AAMR: 16.6; 95%CI: 16.5-16.7), followed by the Midwestern region (AAMR: 14.4; 95%CI: 14.314.4). Significant variations in AAMR were observed among different states, with Oklahoma recording the highest (21.2) and Connecticut the lowest (7). The CDC WONDER database could potentially have omissions or inaccuracies. It does not provide data outside of the available variables. Furthermore, dataset after 2020 was not included in this study.

CONCLUSION

Our findings highlight an alarming rise in mortality related to renal complications of diabetes among United States adults over the past two decades, with concerning disparities across demographic and geographic factors. These results underscore the urgent need for targeted interventions, policies, and protocols to address the growing burden of diabetic nephropathy and substantially reduce mortality rates in the United States. This will help improve the overall health outcome in the United States by identifying communities at risk and implementing tailored assistance to them.

Keywords: Kidney diseases; Mortality; Chronic disease; Comorbidity; Diabetes mellitus

Core Tip: This study focused on investigating renal complications of diabetes mellitus through implementing a large United States database. Our analysis aimed to display mortality rates resulting from renal complications of diabetes on a large scale. The results showed gender, racial, and geographic disparities with higher mortality risk in male patients, native Indian/Alaskan, western states, and nonmetropolitan areas. These disparities emphasized on the importance of involving and encouraging healthcare stakeholders to take further action to improve healthcare specially for vulnerable populations.