Related Experiment Video
Updated: Nov 19, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Two-Week Burden of Arrhythmias across CKD Severity in a Large Community-Based Cohort: The ARIC Study
Esther D Kim1,2, Elsayed Z Soliman3, Josef Coresh1,2
1Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Insights
Chronic kidney disease (CKD) is linked to more arrhythmias, including atrial fibrillation (AF) and ventricular tachycardia, especially with higher albuminuria. This study used 2-week ECG monitoring to reveal a wider range of arrhythmias in CKD patients.
Area of Science:
- Cardiology
- Nephrology
- Epidemiology
Background:
- Chronic kidney disease (CKD) is a known risk factor for sudden cardiac death and atrial fibrillation (AF).
- The full spectrum of arrhythmias and their burden in relation to CKD severity remains incompletely understood.
Purpose of the Study:
- To quantify the burden of various arrhythmias across different stages of CKD.
- To investigate the association between CKD measures (eGFR and albuminuria) and the presence, frequency, and duration of arrhythmias.
Main Methods:
- Analysis of 2-week electrocardiogram (ECG) monitoring data from 2257 community-dwelling older adults (aged 71-94 years) in the Atherosclerosis Risk in Communities study.
- Examination of major arrhythmias, including AF, nonsustained ventricular tachycardia, long pauses, and atrioventricular block.
- Assessment of arrhythmia burden by presence, frequency, and percentage of time in arrhythmia.
Main Results:
- Higher prevalence of AF and nonsustained ventricular tachycardia was observed in individuals with more severe CKD.
- Albuminuria was consistently associated with increased AF prevalence/time and nonsustained ventricular tachycardia.
- Lower eGFR correlated with less frequent atrioventricular block, while higher albuminuria was linked to more frequent ventricular ectopy.
Conclusions:
- CKD, particularly indicated by albuminuria, is associated with a significantly higher burden of AF and nonsustained ventricular tachycardia.
- CKD severity, measured by eGFR and albuminuria, influences the frequency of specific arrhythmias like atrioventricular block and ventricular ectopy.
- Novel 2-week ECG monitoring revealed a broader association between CKD and arrhythmias than previously documented.
Background:
CKD is associated with sudden cardiac death and atrial fibrillation (AF). However, other types of arrhythmia and different measures of the burden of arrhythmias, such as presence and frequency, have not been well characterized in CKD.
Methods:
To quantify the burden of arrhythmias across CKD severity in 2257 community-dwelling adults aged 71-94 years, we examined associations of major arrhythmias with CKD measures (eGFR and albuminuria) among individuals in the Atherosclerosis Risk in Communities study. Participants underwent 2 weeks of noninvasive, single-lead electrocardiogram monitoring. We examined types of arrhythmia burden: presence and frequency of arrhythmias and percent time in arrhythmias.
Results:
Of major arrhythmias, there was a higher prevalence of AF and nonsustained ventricular tachycardia among those with more severe CKD, followed by long pause (>30 seconds) and atrioventricular block. Nonsustained ventricular tachycardia was the most frequent major arrhythmia (with 4.2 episodes per person-month). Most participants had ventricular ectopy, supraventricular tachycardia, and supraventricular ectopy. Albuminuria consistently associated with higher AF prevalence and percent time in AF, and higher prevalence of nonsustained ventricular tachycardia. When other types of arrhythmic burden were examined, lower eGFR was associated with a lower frequency of atrioventricular block. Although CKD measures were not strongly associated with minor arrhythmias, higher albuminuria was associated with a higher frequency of ventricular ectopy.
Conclusions:
CKD, especially as measured by albuminuria, is associated with a higher burden of AF and nonsustained ventricular tachycardia. Additionally, eGFR is associated with less frequent atrioventricular block, whereas albuminuria is associated with more frequent ventricular ectopy. Use of a novel, 2-week monitoring approach demonstrated a broader range of arrhythmias associated with CKD than previously reported.
Related Concept Videos
01:24Chronic Kidney Disease II: Clinical Manifestations
01:18Chronic Kidney Disease IV: Nursing Management
01:25Chronic Kidney Disease I: Introduction
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:28Chronic Kidney Disease III: Interprofessional Care
01:20Acute Kidney Injury V: Interprofessional Care