Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Dec;57(1):2540021.
doi: 10.1080/07853890.2025.2540021. Epub 2025 Aug 6.

The mortality of chronic kidney disease in Chinese subjects: a 12-year cohort based on clinical data in electronic health record

Qingyu Niu  1 , Mei Hao  2 , Mi Wang  1 , Zhun Sui  1 , Li Zuo  1
Affiliations

The mortality of chronic kidney disease in Chinese subjects: a 12-year cohort based on clinical data in electronic health record

Qingyu Niu et al. Ann Med. 2025 Dec.

Abstract

Background: Chronic kidney disease (CKD) is a global health problem with increasing prevalence. The objective of this study was to investigate the CKD mortality rate in a large cohort study based on electronic health record (EHR).

Methods: This was a retrospective cohort based on Hospital's EHR. The follow-up period was from January 2008 to December 2019. We used demographics, laboratory tests, comorbidities and mortality information to do the analysis. The mortality data was gained from the Chinese Center for Disease Control and Prevention (CDC) database. Then the data was analyzed in the whole participants and subgroups.

Results: 82,684 CKD patients were identified in final cohort. Overall, there were 10,454 patients who died during the 12-year follow-up. The crude mortality rate was 12.6% (2.4 per 100 patient-years). In CKD stages 4-5, the mortality rate significantly increased (10.2 and 8.8 per 100 patient-years, respectively). The major causes of death including cardiovascular diseases, infections and cancer. In the advanced (stages 4-5) CKD, the proportion of deaths caused by cancer significantly decreased (15-26% to 9-10%), while the proportion of deaths caused by renal failure markedly increased (2-4% to 10-21%). In the death group, patients with younger baseline age have a higher proportion of reaching ESRD before death: among patients with baseline age ≤35 years, for example, the percentage who died with ESKD was 28.8%, and the percentage of died with ESKD in patients with baseline age >80 years was only 14.9%.

Conclusion: In conclusion, among the 82,684 CKD patients, the mortality rate was 2.4 per 100 patient-years. For advanced CKD patients, the mortality rate was significantly increased. As CKD progressed, deaths caused by cancer significantly decreased, while death caused by renal failure remarkably increased. Meanwhile, there may be a competing risk of all-cause mortality and progression to ESKD.

Keywords: Chronic kidney diseases; comorbidities; death causes; end-stage renal disease; mortality.

PubMed Disclaimer

Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Flow chart of study population selection.
Figure 2.
Figure 2.
The CKD mortality rates in age subgroups.
Figure 3.
Figure 3.
The distribution of death causes in different CKD stages.
Figure 4.
Figure 4.
The distribution of death causes in diabetic and non-diabetic patients.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Jha V, Garcia-Garcia G, Iseki K, et al. Chronic kidney disease: global dimension and perspectives. Lancet. 2013;382(9888):260–272. doi: 10.1016/S0140-6736(13)60687-X. - DOI - PubMed
    1. GBD Chronic Kidney Disease Collaboration . Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395(10225):709–733. doi: 10.1016/S0140-6736(20)30045-3. - DOI - PMC - PubMed
    1. Hill NR, Fatoba ST, Oke JL, et al. Global prevalence of chronic kidney disease - a systematic review and meta-analysis. PLoS One. 2016;11(7):e0158765. doi: 10.1371/journal.pone.0158765. - DOI - PMC - PubMed
    1. Wang L, Xu X, Zhang M, et al. Prevalence of chronic kidney disease in China: results from the sixth China chronic disease and risk factor surveillance. JAMA Intern Med. 2023;183(4):298–310. doi: 10.1001/jamainternmed.2022.6817. - DOI - PMC - PubMed
    1. White SL, Polkinghorne KR, Atkins RC, et al. Comparison of the prevalence and mortality risk of CKD in Australia using the CKD Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) Study GFR estimating equations: the AusDiab (Australian Diabetes, Obesity and Lifestyle) Study. Am J Kidney Dis. 2010;55(4):660–670. doi: 10.1053/j.ajkd.2009.12.011. - DOI - PubMed

LinkOut - more resources