Kidney Function Decline Linked to Atrial Fibrillation Risk

DECREASED kidney function is associated with a greater chance of atrial fibrillation development, new research suggests. Due to the poor clinical outcome of both conditions, this study is of great importance and will pave the way for further investigation into the significant connection between atrial fibrillation and a broad range of kidney function conditions, allowing appropriate therapeutic selection.

The research team, led by Dr Nisha Bansal, University of Washington Medical Centre, Seattle, Washington, USA, conducted a meta-analysis of data from three large prospective studies. Using information from 16,769 community-dwelling individuals from the Jackson Heart Study, the Multi-Ethnic Study of Atherosclerosis, and the Cardiovascular Health Study, the researchers were able to examine the impact of changes in kidney disease parameters such as estimated glomerular filtration rate (eGFR) and urine albumin-to-creatine ratio (UACR).

The results of the study highlighted a substantial stepwise increase in the risk of atrial fibrillation with decreasing kidney function. For example, as the eGFR of individuals decreased from the reference value of 90 mL/min/1.73 m2, a significant increase in the risk of atrial fibrillation was observed; those with an estimated glomerular filtration rate of 60–89, 45–59, 30–44, and <30 mL/min/1.73 m2 had a 9%, 17%, 59%, and 2-fold greater incidence of atrial fibrillation, respectively. In addition, the team also investigated the adjusted risk of atrial fibrillation as associated with increased UACR, a characteristic marker of kidney abnormalities. Compared to healthy controls with a UACR <15 mg/g, kidney disease patients with a UACR of 15–29, 30–299, and ≥300 mg/g had a 4%, 47%, and 76% greater risk of developing atrial fibrillation, respectively.

Drawing conclusions from the study, the team suggested the results provide conclusive evidence that the development of atrial fibrillation can be associated with abnormal kidney function. Dr Bansal noted the importance of the study, explaining: “This study found that even modest abnormalities in kidney function were linked with a higher risk of developing atrial fibrillation later in life.” She noted the risk of atrial fibrillation could be connected to a broad range of conditions related to kidney function decline and it is therefore important to understand this risk in order to improve clinical outcomes.

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