MM-581: Tracking Mortality in Multiple Myeloma-Associated Acute Kidney Injury: U.S. Trends (1999–2023) and ARIMA-Based Projections Through 2050

Document Type

Conference Proceeding

Publication Date

9-1-2025

Publication Title

Clin Lymphoma Myeloma Leuk

Abstract

Acute kidney injury (AKI) affects up to 20% of patients with multiple myeloma (MM), rendering it a significant contributor to the mortality burden of the disease. Our hypothesis posits that MM-associated AKI mortality demonstrates significant socioeconomic and regional disparities. Objectives: This study aims to assess MM-associated AKI mortality trends in U.S. adults (≥65 years) from 1999 to 2023 and project overall trends through 2050 using the CDC WONDER database, focusing on socioeconomic disparities. Methods: Mortality data were obtained from the CDC WONDER database (1999–2023) using ICD-10 codes C90 (MM) and N17 (AKI). Age-adjusted mortality rates (AAMR) were calculated per million and standardized to the 2000 U.S. population. Joinpoint regression analysis estimated annual percent change (APC) and AAMR with 95% confidence intervals (CIs). Stratifications included sex, race, state, region, and urbanization zone. Future AAMR trends were forecasted using ARIMA after ADF-based stationarity testing. Results: From 1999 to 2023, 11,414 deaths occurred due to AKI-associated MM. AAMR increased from 7.7 (95% CI: 6.8–8.7) to 14.1 (95% CI: 13.1–15.1) per million. The ARIMA model fit well (AIC 50.28, RMSE 3.19) and forecasted AAMR values of 10.32 in 2030 (CI: 7.12–13.52), 2040 (CI: 5.49–15.15), and 2050 (CI: 4.29–16.35). In 2050, the projected AAMR for males was 13.56 (95% CI: 5.11–22.02), compared with 8.12 (95% CI: 4.12–12.13) for females. Historically, males had higher AAMR (18.4 per million, 95% CI: 16.7–20.1) than females (11 per million, 95% CI: 9.8–12.1). Non-Hispanic Whites saw a consistent increase in mortality (APC 2.83%, 95% CI 1.92–5.70, P = 0.002), particularly in the South (APC 2.55%, 95% CI 1.77–3.57, P < 0.001), where AAMR rose from 7.3 (95% CI: 5.8–9) to 14 (95% CI: 12.5–15.6). Rural non-core areas had the highest AAMR (13.8 per million, 95% CI 10.2–18.3). South Dakota had the highest state-specific AAMR (16.2 per million, 95% CI: 11.8–21.9). Conclusion: MM-associated AKI mortality among older U.S. adults has increased significantly, particularly affecting males, non-Hispanic Whites, and residents of the southern U.S. and South Dakota. Given the disparities, targeted public health interventions are required to mitigate these inequalities. Grant/Funding Acknowledgements: Nil.

Volume

25

First Page

S928

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