Kidney Week 2019 — Reduced kidney function is an independent risk factor for Afib


  • Marielle Fares, Pharm.D.
  • Conference Reports
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Takeaway

  • Lower glomerular filtration rate (GFR) level was independently associated with a higher burden of Afib in adults with Afib measured by 14-day continuous ambulatory ECG monitoring.
  • Reduced kidney function may increase the risk of stroke through inducing a higher incidence of Afib and Afib burden.

Why this matters

  • Afib is the main risk factor for ischemic stroke; a high Afib burden (i.e., time spent with Afib) independently increases the risk of stroke.
  • Reduced kidney function is associated with higher risk of Afib, yet it is unknown how it influences the Afib burden.

Study design

  • KP RHYTHM included adults who had 14-day continuous ambulatory ECG monitoring between 2011 and 2016.
  • Study patients had GFR estimated by CKD-EPI the year before monitoring, were not receiving renal replacement therapy, and had Afib detected in the monitoring period.
  • Patient-specific characteristics and stroke risk factors were obtained from electronic health records.
  • Researchers analyzed the multivariable association of a 10 mL/minute/1.73 m2 decrease in estimated GFR (eGFR) with Afib burden.

Key results

  • A total of 1069 adults with detected Afib on ambulatory monitoring were enrolled. 
  • Median Afib burden was 4% (interquartile range, 1%-13%).
  • After adjustment for comorbidities (heart failure, hypertension, diabetes mellitus, prior stroke, proteinuria) and demographics, every 10 mL/minute/1.73 m2 lower level of eGFR was independently associated with 10% higher burden of Afib (95% CI, 1.1%-19%).

Limitations

  • Short-term monitoring period of 14 days.