Chronic kidney disease associated with increased AF incidence
MedWire News: Results of the Atherosclerosis Risk in Communities (ARIC) study suggest that chronic kidney disease is independently associated with atrial fibrillation (AF) incidence.
In this large community-based cohort, kidney function at enrolment showed an inverse linear correlation with the risk for AF during 10 years of follow-up, report Alvaro Alonso (University of Minnesota, Minneapolis, USA) and colleagues.
Chronic kidney disease is known to be associated with cardiovascular disease but its link with AF is unclear. To investigate, Alonso's team analyzed data from the ARIC study, identifying 10,328 men and women who were free of/from AF at baseline.
The participants were stratified in two ways: by quartiles of cystatin C-based glomerular filtration rate (eGFRcys) and by tertiles of urinary albumin-to-creatinine ratio (ACR).
Writing in Circulation, the researchers say that there were 788 incident AF cases during a median 10.1 years of follow-up.
After adjusting for multiple covariates, the risk for AF rose steadily in line with declining quartiles of eGFRcys and rising tertiles of ACR.
Compared with those with an eGFRcys at or above 90 ml/min/1.73 m2, the multivariable hazard ratios AF were 1.3, 1.6, and 3.2 for those with an eGFRcys of 60-89, 30-59, and 15-29 ml/min/1.73 m2, respectively.
Similarly, compared with those with normoalbuminuria (ACR <30 mg/g), the multivariable hazard ratios for AF were 3.2 and 2.0 for those with macroalbuminuria (ACR ≥300 mg/g) and microalbuminuria (ACR 30-299 mg/g), respectively.
The two kidney function parameters interacted, such that the risk for AF was highest in those with both a low eGFRcys (15-29 ml/min/1.73 m2) and macroalbuminuria, with a hazard ratio of 13.1 compared with patients with normoalbuminuria and a high eGFRcys (≥90 ml/min/1.73 m2).
Alonso et al say that their study "highlights the potential role of chronic kidney disease as a risk factor for AF" and conclude: "Interventions aimed at preventing and treating chronic kidney disease could also contribute to reduce the burden of AF in the population."
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By Joanna Lyford