Clinical InvestigationElectrophysiologyClose bidirectional relationship between chronic kidney disease and atrial fibrillation: The Niigata preventive medicine study
Section snippets
Study subjects
This community-based, observational cohort study was based on a program of voluntary annual health examinations in the Niigata Association for Comprehensive Health Promotion and Research, Niigata, Japan.19 In the prefecture, annual health examinations supported by administration are available to residents ≥20 years of age. The population of the prefecture is about 2 400 000, and about 250 000 residents (~50% of subjects) receive the examination during one year. The annual examination consists
Association of kidney disease with development of AF
The entire cohort, which was analyzed for the association of kidney disease with development of AF, included 223,877 subjects after elimination of the subjects with exclusions (Figure 1). The mean age was 60.9 ± 11.7 years and 68% of subjects were women (Table I). The mean serum creatinine was 0.6 ± 0.2 mg/dL at the baseline and the mean estimated GFR was 102.6 ± 25.1 mL/min per 1.73 m2. Subjects with baseline GFR 30-59 mL/min per 1.73 m2 and GFR <30 mL/min per 1.73 m2 were identified in 1.7%
Discussion
In this general population of adults, we have shown a close association between AF and kidney disease: kidney disease was associated with the development of AF and AF was associated with the development of kidney disease. Although hypertension and diabetes are known as strong risk factors for subsequent AF and kidney disease,17, 18, 20, 21 both associations remained significant in subjects without hypertension or diabetes.
Associations have previously been described between AF and chronic kidney
Conclusions
We found that there is an association between kidney disease and AF, even in the absence of hypertension and diabetes. We suggest that disrupted multiple signaling pathways may be critical for the pathogenesis of both diseases and, potentially, their interaction. Chronic kidney disease and AF are associated with increased incidence of cardiovascular events and high mortality, and our findings further propose the importance of management of these diseases to prevent subsequent events and to
References (53)
- et al.
A population-based study of the long-term risks associated with atrial fibrillation: 20-year follow-up of the Renfrew/Paisley study
Am J Med
(2002) - et al.
Prevalence of atrial fibrillation and associated factors in a population of long-term hemodialysis patients
Am J Kidney Dis
(2005) - et al.
Insulin resistance and hyperinsulinemia are already present in patients with incipient renal disease
Kidney Int
(1998) - et al.
Cardiovascular disease in patients with chronic kidney disease: getting to the heart of the matter
Am J Kidney Dis
(2001) - et al.
Inflammation, endothelial dysfunction, and platelet activation in patients with chronic kidney disease: the chronic renal impairment in Birmingham (CRIB) study
Am J Kidney Dis
(2004) - et al.
Increased expression of extracellular signal-regulated kinase and angiotensin-converting enzyme in human atria during atrial fibrillation
J Am Coll Cardiol
(2000) - et al.
Prevention of atrial fibrillation with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: a meta-analysis
J Am Coll Cardiol
(2005) - et al.
Angiotensin II receptor blockade reduces new-onset atrial fibrillation and subsequent stroke compared to atenolol: the Losartan Intervention For End Point Reduction in Hypertension (LIFE) study
J Am Coll Cardiol
(2005) - et al.
Interleukin-6 predicts hypoalbuminemia, hypocholesterolemia, and mortality in hemodialysis patients
Am J Kidney Dis
(1998) - et al.
A controlled, prospective study of the effects of atorvastatin on proteinuria and progression of kidney disease
Am J Kidney Dis
(2003)
Effect of rosuvastatin on C-reactive protein and renal function in patients with chronic kidney disease
Am J Cardiol
Role of inflammation in initiation and perpetuation of atrial fibrillation: a systematic review of the published data
J Am Coll Cardiol
Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study
JAMA
Lifetime risk for development of atrial fibrillation: the Framingham Heart Study
Circulation
Atrial fibrillation as an independent risk factor for stroke: the Framingham Study
Stroke
Impact of atrial fibrillation on the risk of death: the Framingham Heart Study
Circulation
Rising rates of hospital admissions for atrial fibrillation
Epidemiology
Increasing trends in hospitalization for atrial fibrillation in the United States, 1985 through 1999: implications for primary prevention
Circulation
Projecting the number of patients with end-stage renal disease in the United States to the year 2015
J Am Soc Nephrol
Overview of regular dialysis treatment in Japan (as of 31 December 2005)
Ther Apher Dial
Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization
N Engl J Med
Cardiovascular disease and subsequent kidney disease
Arch Intern Med
Symptomatic atrial arrhythmias in hemodialysis patients
Ren Fail
Clinical characteristics associated to atrial fibrillation in chronic hemodialysis patients
Clin Nephrol
Postcardiac surgery complications: association of acute renal dysfunction and atrial fibrillation
Anesth Analg
Atrial fibrillation after coronary artery bypass grafting in elderly patients: incidence and risk factor analysis
Thorac Cardiovasc Surg
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