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New-onset Atrial Fibrillation is Associated With Polycystic Kidney Disease: A Nationwide Population-based Cohort

Tung-Min Yu1, Ya-Wen Chuang, Mei-Ching Yu

  • 1From the Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University (T-MY, C-HK); Division of Nephrology, Taichung Veterans General Hospital, Taichung (T-MY, Y-WC); Department of Pediatric Nephrology, Chang Gung Children's Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan (M-CY); Management Office for Health Data, China Medical University Hospital, Taichung (C-LL); Neurology and Medical Intensive Care Unit, Changhua Christian Hospital, Changhua (C-CC); College of Medicine, China Medical University (C-LL); and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan (C-HK).

Medicine
|January 31, 2016
PubMed

Insights

Patients with polycystic kidney disease (PKD) have a significantly higher risk of developing atrial fibrillation (AF). This association strengthens with increased cardiovascular risk factors, warranting vigilance and early treatment in PKD patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Epidemiology

Background:

  • Cardiovascular complications are a leading cause of death in Polycystic Kidney Disease (PKD).
  • Atrial fibrillation (AF) is a common cardiovascular complication with significant morbidity and mortality.
  • The relationship between PKD and AF risk requires further investigation.

Purpose of the Study:

  • To investigate the association between Polycystic Kidney Disease (PKD) and the risk of developing atrial fibrillation (AF).
  • To quantify the incidence and hazard ratio of AF in patients with PKD compared to controls.
  • To explore the impact of combined risk factors on AF incidence in PKD patients.

Main Methods:

  • A nationwide population-based cohort study utilizing inpatient claims data.
  • Inclusion of 7203 patients diagnosed with PKD (1998-2010) without prior AF history.
  • Selection of 28,739 matched controls without PKD, frequency-matched by age, sex, and comorbidity.

Main Results:

  • The incidence of AF was 7.08 per 1000 person-years in the PKD cohort versus 4.98 in the control cohort.
  • Patients with PKD had a 1.31-fold increased risk of AF (aHR=1.31, 95% CI=1.14-1.51).
  • AF risk escalated significantly with increasing numbers of cardiovascular risk factors in PKD patients, reaching an aHR of 3.64 for >5 risk factors.

Conclusions:

  • Polycystic Kidney Disease (PKD) is independently associated with an increased risk of atrial fibrillation (AF).
  • The risk of AF in PKD patients is amplified by the presence of multiple cardiovascular risk factors.
  • Clinical vigilance for irregular heart rhythms and early prophylactic therapy are recommended for PKD patients, especially those with comorbidities.

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