MON-883 - Temporal Trends in Mortality in Renal Failure with Thyroid Disorders

Introduction
Thyroid disorders are increasingly recognized as important modifiers of renal disease outcomes, yet their contribution to renal failure mortality remains poorly defined. This study aimed to characterize long-term mortality trends in renal failure deaths with thyroid disorders listed as a contributing cause.
Methods
A population-based observational study was conducted using national mortality data from the CDC WONDER Multiple Cause of Death database, 1999–2023. Regional analyses were limited to 1999-2020. Renal failure deaths with thyroid disorders recorded as contributing causes among individuals aged ≥35 years were identified. Age-adjusted mortality rates (AAMRs, per 100,000 population) with standard errors were calculated annually. Temporal trends were assessed using annual percent change (APC) and average annual percent change (AAPC) via Joinpoint regression. Stratified analyses were performed by sex, race, census region, and place of death.
Results
From 1999 to 2023, 4,617 individuals (female: 3,137; male: 1,480) aged ≥35 years died from renal failure with thyroid disorders listed as contributing causes in the United States. Annual age-adjusted mortality rates (AAMRs) declined overall, with a significant decrease from 1999–2016 (APC: −4.14%, 95% CI [−5.43 to −2.82]; p< 0.001), followed by a nonsignificant increase from 2016–2023 (APC: 3.97%, 95% CI [−0.55 to 8.69]; p=0.083). Overall mortality showed a significant downward trend across the study period (AAPC: −1.84%, 95% CI [−3.19 to −0.34]; p=0.016). Across all years, females consistently exhibited higher annual AAMRs than males. Trend analyses showed a significant overall decline among males (AAPC: −2.10%, 95% CI [−3.36 to −0.83]; p=0.0025), but not among females (AAPC: 0.11%, 95% CI [−3.72 to 4.09]; p=0.955). White individuals accounted for 89.90% of deaths, followed by Black or African American individuals (8.36%) and Asian or Pacific Islanders (1.46%). Regionally (1999–2020), mortality was highest in the Northeast and Midwest and lowest in the West. Most deaths occurred in inpatient facilities (48.53%), followed by nursing homes or long-term care facilities (31.12%) and decedents’ homes (17.31%).
Conclusion
Mortality associated with renal failure and thyroid disorders has declined over the past two decades, suggesting improvements in disease management. However, recent stabilization and rising absolute deaths after 2016 highlight persistent vulnerabilities, particularly among older and institutionalized populations. These findings highlight the potential value of targeted thyroid screening in chronic kidney disease and enhanced integrated endocrine–nephrology care to further reduce preventable mortality.

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