New research indicates that U.S.–Mexico border counties experience disproportionately elevated rates of death from chronic kidney disease (CKD), alongside reduced availability of nephrologists. The findings will be presented at ASN Kidney Week 2026, Oct. 22–25.
When investigators analyzed data from the U.S. Centers for Disease Control and Prevention, they found that between 1999 and 2022, CKD-related mortality in U.S.–Mexico border counties increased from 48.2 to 81.4 deaths per 100,000 population, rising approximately 2.7% per year. Over the same period, mortality in nonborder counties increased from 35.1 to 54.4 deaths per 100,000, at approximately 1.3% per year—roughly half the annual pace observed along the border.
There was also a consistent association between nephrology workforce availability and CKD-related mortality. Counties with the lowest nephrologist density had substantially higher mortality than those with the greatest workforce availability (91.4 versus 52.8 deaths per 100,000). Each decrease of one nephrologist per 100,000 population was associated with approximately 7% higher CKD-related mortality after adjusting for diabetes, obesity, poverty, uninsured status, rurality, hospital access and demographic factors.
“Our findings suggest that the U.S.–Mexico border is experiencing a growing kidney health disparity that parallels major geographic differences in access to nephrology care,” said corresponding author Sofia Yamada, M.D., of the University of Texas Rio Grande Valley School of Medicine. “Border counties, many of which are predominantly Hispanic and medically underserved, experienced a substantially faster rise in CKD mortality than nonborder comparison counties.”
Yamada noted that although the county-level ecological analysis cannot establish that workforce shortages cause higher mortality, the association persisted after adjusting for multiple clinical, socioeconomic and health care access factors and raises an important concern.
“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,” she said. “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.”
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US–Mexico border counties face high kidney disease–related mortality and low nephrologist availability (2026, October 23)
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