Impact of Chronic Kidney Disease Classification on New-Onset Atrial Fibrillation in the General Population　― The TAMA MED Project-AF and CKD ―

Abstract

Background: Atrial fibrillation (AF) and chronic kidney disease (CKD) are known risk factors for each other. In Tama City in Tokyo, 12-lead ECG and serum creatinine concentration have been included as essential examinations in specific health checkups to diagnose AF and CKD. In the present study, we investigated the impact of CKD classification on new-onset AF in the general population. Methods and Results: Among 13,478 subjects aged 40-74 years at entry (age, 65.6±7.8 years; men, 42.0%), renal impairment with estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m 2 and proteinuria were found in 15.5% and 4.6%, respectively. CKD severity in individual subjects was classified according to a heatmap of the Japanese Society of Nephrology as 81.3% in the green, 15.1% in the yellow, 2.5% in the orange, and 0.9% in the red. Of those without AF in 2012, it had developed in 115 up to 2017; thus, the new-onset AF incidence rate was 2.6/1,000 person-years. Hazard ratios and 95% confidence intervals for new-onset AF in each CKD classification were 1.50 (0.93-2.41, P=0.097) in the yellow, 2.53 (1.03-6.23, P=0.044) in the orange, and 4.65 (1.47-14.70, P=0.009) in the red compared with the green as a reference. Conclusions: CKD classification was significantly associated with new-onset AF in the general population. Thus, it would be useful for risk stratification of new-onset AF. Renal function evaluation is recommended in health checkups.

Prevalence and risk factors for persistent atrial fibrillation in obstructive sleep apnea

“…Therefore, it is not surprising that AF was increasing by age in OSA patients after adjusting for body mass index ( Table 4 ). This finding was similar to the previous study from Germany even after adjusting for other variables in this study ( Table 4 ) 22 .…”

“…Renal dysfunction had a higher prevalence of OSA and also a predictor of OSA in the elderly with an adjusted odds ratio of 2.32 (95%CI = 1.63, 3.31) 20 . Chronic kidney disease was reported to be a risk factor for new-onset AF (hazard ratio 4.65; 95%CI = 1.47, 14.70) by a study from Japan 22 . Therefore, increasing the glomerular filtration rate may reduce the risk of AF in OSA by 4% per 1ml/min/1.73m 2 ( Table 4 ).…”

Sarcopenia and coexistent risk factors detected using the ‘Yubi-wakka’ (finger-ring) test in adults aged over 65 years in the public annual health check-up in Tama City, Tokyo: a cross-sectional study

“…The TAMA MED Projects (Project Atrial Fibrillation, [3][4][5] Chronic Kidney Disease [4][5][6] and Frail 2 ) were conducted by the Tama City Medical Association to analyse consecutive annual health check-up data for national health insurance in Japan. All authors contributed to this work and agreed with the content of the present manuscript.…”

Factors Influencing Sarcopenic Changes in YUBI-WAKKA Finger-Ring Test Results After One Year: A Retrospective Observational Study

“…The TAMA MED projects (Frail [ 2 , 3 ], AF [ 4 ], CKD [ 5 , 6 ]) have been conducted by the Tama City Medical Association to analyze consecutive annual health checkup data performed under the National Health Insurance. This cross-sectional study retrospectively observed the prevalence of sarcopenia using the finger-ring test, evaluated any test result changes after 1 year, and analyzed factors relating to these changes.…”