Ischemic stroke is among the leading causes of death in the United States and when accompanied by renal failure, outcomes worsen significantly. This study evaluates the mortality burden and accompanied impact of Ischemic stroke with renal failure.

A descriptive study was conducted using CDC WONDER data from 1999–2020, including adults aged ≥25. ICD-10 codes used were I63 (Ischemic stroke) and N17-N19 (Renal failure). Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated and stratified by sex, race, census region, urbanization, and state. Joinpoint regression estimated annual percent changes (APCs) with 95% confidence intervals (CIs).

Between 1999 and 2020, 26,024 U.S. adult deaths (≥25 years) were attributed to ischemic stroke with renal failure (13,043 females; 12,981 males). The AAMR declined from 0.97 in 1999 to 0.39 in 2008 (APC: –10.76), rose to 0.46 in 2011 (APC: 5.85), dropped to 0.31 in 2014 (APC: –13.19), and increased to 0.76 in 2020 (APC: 17.59). In 2020, AAMR was higher in males (0.86) than females (0.63). By race, Black had the highest AAMR (1.32), followed by Hispanics (0.86), Whites (0.63), and Asian (0.62). Statewise, AAMR ranged from 0.58 in Pennsylvania to 1.46 in Texas (0.7 in California, 0.87 in North Carolina). AAPC was highest in Non-Core areas (0.03), followed by Medium Metro (–0.28), Micropolitan (–0.44), Small Metro (–0.96), Large Central Metro (–1.18), and Large Fringe Metro (–2.16). Regionally, the South showed the highest AAPC (–0.29), followed by West (–0.71), Midwest (–1.52), and Northeast (–2.60).

Mortality from ischemic stroke with renal failure has fluctuated, with recent rises and persistent sex, race, and regional disparities, emphasizing need for equitable prevention and care.