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Causal effect of atrial fibrillation/flutter on chronic kidney disease: A bidirectional two-sample Mendelian

Masahiro Yoshikawa1, Kensuke Asaba2, Tomohiro Nakayama1

  • 1Division of Laboratory Medicine, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan.

Plos One
|December 13, 2021
PubMed

Insights

Atrial fibrillation may cause chronic kidney disease (CKD), but CKD is unlikely to cause atrial fibrillation. This Mendelian randomization study suggests a causal link between atrial fibrillation and increased CKD risk in Europeans.

Area of Science:

  • Nephrology
  • Cardiology
  • Genetics

Background:

  • Chronic kidney disease (CKD) and atrial fibrillation (AF) are significant global health concerns.
  • Observational studies suggest an association between CKD and AF, but causality is unclear due to potential confounding and reverse causation.

Purpose of the Study:

  • To investigate the causal relationship between CKD and AF using bidirectional two-sample Mendelian randomization.
  • To analyze these associations within the European population.

Main Methods:

  • Utilized publicly available genome-wide association study summary statistics.
  • Employed bidirectional two-sample Mendelian randomization analysis.
  • Included data from the CKDGen consortium and UK Biobank.

Main Results:

  • A causal effect of atrial fibrillation/flutter risk on decreased estimated glomerular filtration rate (eGFR) was suggested.
  • A significant causal effect of atrial fibrillation/flutter risk on the risk of CKD was identified (OR, 9.39; P = 0.001).
  • A causal effect of decreased eGFR on atrial fibrillation/flutter risk was deemed unlikely.

Conclusions:

  • The findings suggest atrial fibrillation may causally increase the risk of developing CKD.
  • The reverse causal pathway from CKD to AF appears unlikely.
  • Further research is needed to understand the underlying mechanisms, and limitations include a relatively small sample size and potential selection bias.

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