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Published on: February 26, 2013
Association of Loop Diuretic Use with Hospitalization with Atrial Fibrillation in CKD
Katherine Scovner Ravi1,2, Armida LeFranc Torres1,2, Finnian R Mc Causland1,2
1Brigham and Women's Hospital, Boston, MA, USA.
Kidney360
|May 15, 2026
Summary
Loop diuretic use in chronic kidney disease (CKD) patients without atrial fibrillation is linked to a higher risk of developing the condition. This association may be stronger in those with a history of heart failure.
Area of Science:
- Nephrology
- Cardiology
- Clinical Pharmacology
Background:
- Chronic kidney disease (CKD) significantly increases cardiovascular complication risk, notably atrial fibrillation.
- Loop diuretics are common in CKD management but their link to new-onset atrial fibrillation is unclear.
Purpose of the Study:
- To investigate the association between loop diuretic use and incident atrial fibrillation in CKD patients.
- To explore potential effect modification by sex, heart failure history, and CKD stage.
Main Methods:
- Utilized data from 4,607 CKD patients without baseline atrial fibrillation from the CRIC cohort.
- Employed adjusted Cox regression models to assess loop diuretic use and atrial fibrillation hospitalization.
- Controlled for demographics, cardiovascular risk factors, kidney function, and other medications.
Main Results:
- Baseline loop diuretic use was associated with a 41% increased risk of atrial fibrillation hospitalization (aHR 1.41).
- The association was not significantly modified by sex or CKD stage.
- A trend suggested a stronger association in patients with heart failure (aHR 3.00) versus those without (aHR 1.33).
Conclusions:
- Loop diuretic use is independently associated with subsequent atrial fibrillation hospitalization in CKD patients.
- This association may be more pronounced in patients with a history of heart failure.
- Further research is needed to understand the underlying mechanisms.
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