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Published on: February 26, 2013
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Kidney Function, Albuminuria, and Risk of Incident Atrial Fibrillation: A Systematic Review and Meta-Analysis.
Jeffrey T Ha1, S Ben Freedman2, Dearbhla M Kelly3
1The George Institute for Global Health, Sydney, NSW, Australia; Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; Department of Renal Medicine, St George Hospital, Sydney, NSW, Australia.
Summary
Chronic kidney disease (CKD) markers, including lower estimated glomerular filtration rate (eGFR) and albuminuria, are independently linked to a higher risk of developing new-onset atrial fibrillation (AF). This suggests CKD should be recognized as a significant risk factor for AF.
Area of Science:
- Nephrology
- Cardiology
- Epidemiology
Background:
- Atrial fibrillation (AF) and chronic kidney disease (CKD) frequently coexist, but CKD's role as an independent risk factor for incident AF remains unclear.
- This study investigates the association between CKD markers (eGFR and albuminuria) and the risk of developing new-onset AF.
Approach:
- A systematic review and meta-analysis of 38 cohort studies and randomized controlled trials.
- Included data from over 28 million participants, analyzing incident AF risk based on eGFR and albuminuria levels.
Key Points:
- Lower eGFR (<60 mL/min/1.73m² vs ≥60) was associated with a 43% increased risk of incident AF (RR, 1.43; 95% CI, 1.30-1.57).
- Albuminuria, particularly moderate to severe levels, was linked to a 64% higher risk of incident AF (RR, 1.64; 95% CI, 1.31-2.06).
- An exposure-dependent association was observed, with risk increasing progressively at lower eGFR and higher albuminuria categories.
Conclusions:
- Reduced eGFR and increased albuminuria are independently associated with a significantly higher risk of incident AF.
- CKD should be considered an independent risk factor for the development of atrial fibrillation.
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