Frequency of atrial fibrillation and factors related to its development in dialysis patients

The frequency of atrial fibrillation is increased in patients with end-stage renal disease. In this study, we sought to determine the incidence of persistent and paroxysmal atrial fibrillation in patients with end-stage renal disease and to identify the risk factors associated with this arrhythmia.

Two hundred seventy-five patients with end-stage renal disease who were in a hemodialysis program for at least 4 months were included in the study. Patients with permanent, persistent, or paroxysmal atrial fibrillation were identified and recorded. All patients were evaluated for cardiac risk factors and arrhythmias.

Thirty (10.9%) of the 275 patients were found to have atrial fibrillation. Ten (33.3%) of these patients had permanent or persistent atrial fibrillation, and 20 (66.6%) of these patients had paroxysmal atrial fibrillation. Patients with atrial fibrillation were older. Incidences of hypertension, coronary artery disease, left ventricular systolic dysfunction, right atrial diameters, and mitral and/or aortic calcification were significantly higher in patients with atrial fibrillation. Serum albumin and high-density lipoprotein levels were significantly lower in patients with atrial fibrillation.

Our data indicate that atrial fibrillation is a frequent arrhythmia in patients with end-stage renal disease, and the most frequently encountered form is paroxysmal atrial fibrillation. In this patient group, presence of coronary artery disease, age, and right atrial diameter are independent factors for determination of the risk of development of atrial fibrillation.