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The Association Between Chronic Kidney Disease and Third-Degree Atrioventricular Block: A Danish Nationwide Study

Hannah K Wood-Kurland1, Anne Storgaard Nørskov2, Nicholas Carlson3

  • 1Department of Cardiology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark; Department of Cardiology, North Zealand Hospital, Hillerød, Denmark; Royal Library, Copenhagen University Library Incl. UH, Copenhagen, Denmark.

JACC. Clinical Electrophysiology
|December 21, 2024
PubMed

Insights

Chronic kidney disease (CKD) is linked to a higher risk of third-degree atrioventricular block (3AVB). This association is particularly strong in patients undergoing dialysis, highlighting a critical connection between kidney health and heart rhythm.

Area of Science:

  • Cardiology
  • Nephrology
  • Epidemiology

Background:

  • Chronic kidney disease (CKD) is associated with increased cardiac arrhythmias and sudden cardiac death.
  • The specific relationship between CKD and third-degree atrioventricular block (3AVB) remains under-investigated.

Purpose of the Study:

  • To investigate the association between chronic kidney disease (CKD) and the occurrence of third-degree atrioventricular block (3AVB).

Main Methods:

  • A population-based nested case-control study utilizing Danish administrative registries from 1995-2018.
  • Identified 31,301 patients with 3AVB, matched 1:5 with controls.
  • Employed multivariable Cox and logistic regression to analyze CKD association and pacemaker implantation odds, stratified by dialysis status.

Main Results:

  • A significant association was observed between CKD and 3AVB (HR: 1.83; 95% CI: 1.73-1.93) after adjusting for confounders.
  • The association was markedly stronger in dialysis patients (HR: 7.71; 95% CI: 5.84-10.18) compared to non-dialysis CKD patients (HR: 1.73; 95% CI: 1.64-1.83).
  • Pacemaker implantation odds were lower in dialysis patients (OR: 0.77; 95% CI: 0.60-0.98) but similar for non-dialysis CKD and no CKD.

Conclusions:

  • CKD is an independent risk factor for third-degree atrioventricular block (3AVB).
  • Patients with CKD, especially those on dialysis, face a substantially elevated risk of 3AVB.
  • Findings underscore the importance of cardiac monitoring in CKD patients.
Abstract

Keywords:
atrioventricular blockchronic kidney diseaseimplantable cardioverter-defibrillatorpacemaker

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