Objective:
Chronic kidney disease (CKD) is well established risk factor for atrial fibrillation (AFib). Our aim was to analayse association of CKD with AFib in patients with AFib form from Croatian cohort of the ESH A Fib survey. We are reporting new data obtained on larger number of patients.
Design and method:
Consecutive sample of 301 patients with AFib (176 M, 125 F; averaged age 70.8) was enrolled in period 2014–2018. Data were collected from medical records. BP was measured following the ESH/ESC guidelines. Hypertension (HT) was defined as BP > 140/90 mmHg and/or antihypertensive drugs treatment, chronic kidney disease (CKD) was defined as eGFR (CKD Epi < 60 ml/min).
Results:
CKD was diagnosed in 45.2% of patients (13.3% CKD stage >3). CKD patients were older than non-CKD (73.0 vs. 68.6) and had more frequently coronary heart disease, heart failure and known significant valvular disease (25.7% vs. 11.5%, p < 0.05; 91.9% vs.22.4%, p < 0.001; 45.6% vs.19.4%, p < 0.01, respectively). Prevalence of HT was higher in CKD patients (98.7% vs. 82.3%; p = 0.03), but there were no differences in control of HT between CKD and non-CKD patients. CKD patients had significantly more CHADVASC > 2 than non-CKD patients (93.7% vs. 75.4%;p = 0.01). In the linear regression analysis higher CHADVASC score was independently positively associated with age and peripheral arterial disease (PAD) while negatively with glomerular filtration rate (GFR). Older patients, CHADVASC score >2 and PAD had increased OR for presence of CKD of 1.03, 1.22 and 0.44, respectively.
Conclusions:
CKD is highly prevalent in patients with AFib and substantial numbers of patients are in advanced CKD stages. Prevalence of HT and CV comorbidity 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. Age, PAD and lower GFR are independent predictors for higher CHADVASC score. To summarize, AFib patients with higher CHADVASC score, older age and the presence of PAD have an increased risk to be associated with CKD.
