Chronic kidney disease (CKD) is well established risk factor for atrial fibrillation (AFib). The aim of the study was to analyze association of CKD and AFib in the consecutive sample of patients with AFib who were admitted to the UHC Zagreb Cardiology Clinic, part of the ESH Excellence centre of hypertension. This cohort is part of the ESH –FA project.
Design and method:
Consecutive sample of 201 patients with AFib (115 M, 86 F; averaged age 71.6) was enrolled in period 2014–2016. Data were collected from medical records. BP was measured following the ESH/ESC guidelines. Hypertension (HT) was defined as BP equel or greater than 140/90 mmHg and/or antihypertensive drugs treatment, chronic kidney disease (CKD) was defined as eGFR (CKD Epi < 60 ml/min).
CKD was diagnosed in 52.2% of patients with AFib, and 13.3% were in CKD stage > 3. CKD patients were older than non-CKD (72.2 vs. 68.3). Coronary heart disease, heart failure and known significant valvular disease were more frequently presented in CKD patients (64.4% vs. 47.2%, p = 0.05; 64.4% vs.44.5%, p = 0.02; 38.9% vs.21.6%, p = 0.02, respectively). Prevalence of HT was higher in CKD patients (92.4% vs. 77.1%; p = 0.02), but there were no differences in control of HT between CKD and non-CKD patients. Permanent and persistent AFib were more frequently diagnosed in CKD, while first diagnosed and paroxysmal AFib were more frequently diagnosed in non-CKD patients (p = 0.003). CKD patients had significantly more CHADVASC > 2 than non-CKD patients (90.2% vs. 70%; p = 0.004).
CKD is highly prevalent in patients with AFib and substantial numbers of patients are in advanced CKD stages. Prevalence of HT and CV comorbidity, as well as prevalence of permanent and persistent AFib are much more frequently presented in CKD than in non-CKD patients. Compared to non-CKD patients, CHADVASC was more often above 2 in CKD patients. In general, AFib patients with associated CKD have higher global CV risk as well higher risk for future thromboembolic incidents than non-CKD AFib patients.