Prevalence of Atrial Fibrillation and Its Predictors in Nondialysis Patients with Chronic Kidney Disease

Ananthapanyasut, Wanwarat; Napan, Sirikarn; Rudolph, Earl H.; Harindhanavudhi, Tasma; Ayash, Husam; Guglielmi, Kelly E.; Lerma, Edgar V.

doi:10.2215/cjn.03170509

Cited by 138 publications

(111 citation statements)

References 48 publications

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“…The estimated prevalence of AF in these patients is reported to be in the range of 7.0–27.0% [8,9]. Ananthapanyasut et al [10] reported a 21.2% (n = 214) incidence of AF among 1,010 nondialysis CKD patients. In addition, according to the Dialysis Outcomes and Practice Patterns Study (DOPPS), 12.5% (n = 2,188) of 17,513 dialysis patients had preexisting AF at baseline [11].…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Cardiovascular Outcomes of Hemodialysis Patients with Atrial Fibrillation: A Prospective Follow-Up Study

Fujii

Kim²,

Kawaguchi³

et al. 2011

Am J Nephrol

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Background/Aims: Among the cardiovascular complications in dialysis patients, atrial fibrillation (AF) is the most common arrhythmia. The purpose of this study was to clarify the characteristics and mortality of hemodialysis patients with AF, which are not completely elucidated. Methods: The prevalence of AF in patients undergoing hemodialysis in our institutions was assessed. Patients with AF (AF group) and without AF (control group) were included in this study. Patients in the control group were matched for several important clinical risk factors. For further analysis, AF patients were divided into two groups on the basis of the type of AF (chronic AF (CAF) and paroxysmal AF (PAF) groups). These patients were evaluated for their clinical characteristics, laboratory data and echocardiographic parameters and prospectively followed up for 48 months. Results: Among 328 study patients, 30 had AF (9.1%). Left atrial diameter (LAD) and the left ventricular mass index were significantly greater in the AF group than in the control group. Furthermore, cardiovascular and all-cause mortality and cumulative incidence of cardiovascular events were significantly higher in the AF group than in the control group, and tended to be higher in the CAF group. Conclusions: Our findings demonstrated that the prevalence of AF as 9.1% in hemodialysis patients, and that AF, especially CAF, were associated with high mortality.

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Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Cardiovascular Outcomes of Hemodialysis Patients with Atrial Fibrillation: A Prospective Follow-Up Study

Fujii

Kim²,

Kawaguchi³

et al. 2011

Am J Nephrol

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“…11 Other studies also found increasing prevalence of AF with decreasing renal function. 12,13 In dialysisdependent patients with CKD stage 5, the prevalence of AF was estimated to range between 3.5% and 27%, depending on AF type.…”

Section: Ckd and Atrial Fibrillationmentioning

confidence: 99%

Preventing Stroke in Patients With Chronic Kidney Disease and Atrial Fibrillation

Reinecke¹,

Engelbertz²,

Schäbitz³

2013

Stroke

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10,11

Clinical Perspective on p 970

Background-Renal impairment increases the risk of stroke and bleeding in patients with atrial fibrillation.

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confidence: 99%

Efficacy and Safety of Dabigatran Compared With Warfarin in Relation to Baseline Renal Function in Patients With Atrial Fibrillation

et al. 2014

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I mpaired renal function is associated with a higher prevalence of atrial fibrillation (AF) [1][2][3] and with an increased risk of thromboembolic events in patients with nonvalvular AF. [4][5][6][7] Current guidelines recommend treatment with oral anticoagulants for AF patients at risk for stroke 8 ; however, impaired renal function also confers a substantially increased risk of major bleeding 9 and often contributes to underutilization of oral anticoagulation therapy in AF populations. 10,11 Clinical Perspective on p 970Background-Renal impairment increases the risk of stroke and bleeding in patients with atrial fibrillation. In the Randomized Evaluation of Long-Term Anticoagulant Therapy (RELY) trial, dabigatran, with ≈80% renal elimination, displayed superiority over warfarin for prevention of stroke and systemic embolism in the 150-mg dose and significantly less major bleeding in the 110-mg dose in 18 113 patients with nonvalvular atrial fibrillation. This prespecified study investigated these outcomes in relation to renal function. Methods and Results-Glomerular filtration rate was estimated with the Cockcroft-Gault, Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), and Modification of Diet in Renal Disease (MDRD) equations in all randomized patients with available creatinine at baseline (n=17 951), and cystatin C-based glomerular filtration rate was estimated in a subpopulation with measurements available (n=6190). A glomerular filtration rate ≥80, 50 to <80, and <50 mL/ min was estimated in 32.6%, 47.6%, and 19.8% and in 21.6%, 59.6%, and 18.8% of patients based on Cockcroft-Gault and CKD-EPI, respectively. Rates of stroke or systemic embolism, major bleeding, and all-cause mortality increased as renal function decreased. The rates of stroke or systemic embolism were lower with dabigatran 150 mg and similar with 110 mg twice daily compared with warfarin, without significant heterogeneity in subgroups defined by renal function (interaction P>0.1 for all). For the outcome of major bleeding, there were significant interactions between treatment and renal function according to CKD-EPI and MDRD equations, respectively (P<0.05). The relative reduction in major bleeding with either dabigatran dose compared with warfarin was greater in patients with glomerular filtration rate ≥80 mL/min. Conclusions-The efficacy of both dosages of dabigatran was consistent with the overall trial irrespective of renal function.However, with the CKD-EPI and MDRD equations, both dabigatran dosages displayed significantly lower rates of major bleeding in patients with glomerular filtration rate ≥80 mL/min. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00262600.

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Prevalence of Atrial Fibrillation and Its Predictors in Nondialysis Patients with Chronic Kidney Disease

Cited by 138 publications

References 48 publications

Clinical Characteristics and Cardiovascular Outcomes of Hemodialysis Patients with Atrial Fibrillation: A Prospective Follow-Up Study

Clinical Characteristics and Cardiovascular Outcomes of Hemodialysis Patients with Atrial Fibrillation: A Prospective Follow-Up Study

Preventing Stroke in Patients With Chronic Kidney Disease and Atrial Fibrillation

Efficacy and Safety of Dabigatran Compared With Warfarin in Relation to Baseline Renal Function in Patients With Atrial Fibrillation

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