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Does Atrial Fibrillation Increase the Risk of Developing End-stage Renal Disease in Patients with Chronic Kidney

Kulachanya Suwanwongse1, Nehad Shabarek1

  • 1Internal Medicine, Lincoln Medical Center, New York City, USA.

Cureus
|March 20, 2020
PubMed

Insights

Atrial fibrillation (AF) significantly increases the risk of end-stage renal disease (ESRD) in patients with chronic kidney disease (CKD). This finding highlights AF as an independent risk factor for CKD progression to ESRD.

Area of Science:

  • Nephrology
  • Cardiology
  • Epidemiology

Background:

  • Atrial fibrillation (AF) is linked to increased risks of stroke, heart failure, and myocardial infarction.
  • The effect of AF on chronic kidney disease (CKD) progression remains unclear.
  • End-stage renal disease (ESRD) represents the final stage of CKD.

Purpose of the Study:

  • To determine if AF is associated with an increased risk of developing ESRD in patients with CKD.
  • To investigate the impact of AF on the progression of CKD.

Main Methods:

  • A systematic search of the MEDLINE database was conducted on January 31, 2019.
  • Included were human, English-language studies evaluating the association between AF and CKD progression to ESRD.
  • One prospective cohort study involving 3,091 CKD patients with a mean follow-up of 5.9 years was analyzed.

Main Results:

  • The study identified 172 CKD patients who developed AF, with 43 progressing to ESRD.
  • Among 2,919 CKD patients without incident AF, 581 progressed to ESRD.
  • The ESRD incidence rate was 11.8 per 100 person-years in patients with AF versus 3.4 per 100 person-years in those without AF.

Conclusions:

  • Atrial fibrillation is an independent risk factor for the development of ESRD in patients with CKD.
  • Further research is required to substantiate these findings and explore underlying mechanisms.

Keywords:
afatrial fibrillationchronic kidney diseaseckdcrdend stage renal disease (esrd)review article

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