New research reveals that chronic kidney disease mortality along the US-Mexico border climbed from 48.2 to 81.4 deaths per 100,000 between 1999 and 2022, rising at roughly twice the annual pace of non-border regions as nephrologist shortages disproportionately impact predominantly Hispanic, medically underserved communities.
The stark geographical divide in kidney health outcomes came to light as researchers prepared findings for presentation at the American Society of Nephrology Kidney Week 2026 meeting in Denver, Colorado. Investigators examining Centers for Disease Control and Prevention records found that chronic kidney disease death rates along the southern border surged by approximately 2.7 percent annually over a 23-year span. By comparison, non-border counties experienced a much slower annual increase of roughly 1.3 percent, moving from 35.1 to 54.4 deaths per 100,000 residents during the same period.
University of Texas Rio Grande Valley School of Medicine Findings on Workforce Gaps
The analysis uncovered a statistical link between medical specialist availability and patient survival. Counties with the lowest nephrologist density recorded substantially higher mortality figures than those with the greatest workforce availability, where death rates reached 91.4 per 100,000 compared to 52.8 in better-staffed regions. Statistical adjustments for diabetes, obesity, poverty, uninsured status, rurality, hospital access, and general demographic factors showed that each reduction of one nephrologist per 100,000 residents correlated with a roughly 7 percent rise in kidney disease mortality.
Our findings suggest that the US–Mexico border is experiencing a growing kidney health disparity that parallels major geographic differences in access to nephrology care.
Sofia Yamada, MD, corresponding author, University of Texas Rio Grande Valley School of Medicine
Border counties face unique demographic and structural hurdles. Many are predominantly Hispanic and medically underserved, absorbing a disproportionate share of systemic healthcare strain. While the county-level ecological design cannot establish that specialist shortages cause higher death rates, the persistent correlation after controlling for multiple confounding variables highlights an urgent public health concern.
Specialist Distribution and Patient Equity at ASN Kidney Week 2026
Workforce deployment affects more than just the southern border states. Medical professionals convening at the Denver conference are confronting systemic inequities in how specialized medical care is distributed nationwide.
Where nephrologists practice may matter profoundly for kidney health equity. Communities carrying some of the greatest burden of kidney disease may also have the least access to the specialized care needed to prevent its progression and complications.
Sofia Yamada, MD, corresponding author, University of Texas Rio Grande Valley School of Medicine
We hope this work encourages policymakers, health systems, and the kidney community to consider the geographic distribution of the nephrology workforce as an important component of efforts to achieve kidney health equity.
Sofia Yamada, MD, corresponding author, University of Texas Rio Grande Valley School of Medicine
Broader Population Trends in Kidney Disease and Malnutrition Mortality
In addition to geographical disparities along the southern border, separate long-term population analyses tracking chronic kidney disease and malnutrition across the United States have mapped significant nationwide trends. Between 1999 and 2024, analyses of adults aged 45 years and older found that the overall age-adjusted mortality rate climbed from 0.89 to 3.22 per 100,000 population.
Demographic breakdowns show that trajectories differ substantially across sex and age groups. Age-adjusted mortality rates remained consistently higher among males than among females throughout the recorded timeframe. Older adults experienced the steepest escalation in risk, with individuals aged 85 years and older seeing crude mortality rates reach 34.30 per 100,000 in 2024.
Readers reviewing these findings should consult qualified healthcare professionals or nephrology specialists for guidance regarding personal kidney health concerns, risk factors, or treatment options.