Multiple Myeloma and Chronic Kidney Disease–Related Mortality, 1999–2023: A Population-Based Time-Trend Analysis

Abstract

Background: Multiple Myeloma (MM) is the second most common hematological cancer, with chronic kidney disease (CKD) representing a major complication. This study aims to analyze national mortality trends, demographic differences, and geographic variation related to MM and CKD. Methods: Nationwide mortality records were obtained from the CDC-WONDER database from 1999 to 2023 among U.S. adults aged ≥45 with MM (C90.0) and CKD (N18); Deaths recorded anywhere on the death certificate (multiple-cause). Age-adjusted mortality rates (AAMRs) per 100,000 populations were calculated for variables. Joinpoint regression analysis was utilized to evaluate annual percent changes (APCs). Results: From 1999 to 2023, a total of 24,606 deaths occurred among adults with MM and CKD in the U.S. The overall AAMR increased from (0.65) in 1999 to (0.86) in 2023 (AAPC: 1.22; 95% CI: 0.54 to 2.00; p<0.001). Males had a higher overall AAMR (1.09) and a more rapid increase (AAPC: 1.40; p<0.001) compared to females (AAMR: 0.60; AAPC: 0.71; p=0.027). Racially, NH Blacks had the highest AAMR (2.14). Regionally, the highest AAMRs were in the South (0.83). Metropolitan areas had a higher overall AAMR 0.81 than Non-metropolitan areas 0.77 (available 1999–2020 only). Most deaths occurred in inpatient medical facilities (46.27%). Among adults aged ≥65 years, overall CMR was 1.80 per 100,000. Conclusion: Mortality from MM and CKD is increasing in the U.S from 1999 to 2023. NH Blacks, males, urban areas and the South region face high burden of death, underscoring the need for targeted strategies to reduce these substantial disparities.