Department of Medicine, University of Illinois at Chicago, Advocate Christ Medical Center, Oak Lawn, Illinois 60453, USA.
Clin J Am Soc Nephrol. 2010 Feb;5(2):173-81. doi: 10.2215/CJN.03170509. Epub 2009 Dec 10.
Chronic kidney disease (CKD) increases systemic inflammation, which is implicated in development and maintenance of atrial fibrillation (AF); therefore, we hypothesized that the prevalence of AF would be increased among nondialysis patients with CKD. This study also reports independent predictors of the presence of AF in this population.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A retrospective, cross-sectional analysis of 1010 consecutive nondialysis patients with CKD from two community-based hospitals was conducted. Estimated GFRs (eGFRs) were calculated using the Modification of Diet in Renal Disease (MDRD) equation. Multivariate logistic regression was used to determine independent predictors.
Of 1010 nondialysis patients with CKD, 214 (21.2%) had AF. Patients with AF were older than patients without AF (76 +/- 11 versus 63 +/- 15 yr). The prevalence of AF among white patients (42.7%) was higher than among black patients (12.7%) or other races (5.7%). In multivariate analyses, age, white race, increasing left atrial diameter, lower systolic BP, and congestive heart failure were identified as independent predictors of the presence of AF. Although serum high-sensitivity C-reactive protein levels were elevated in our population (5.2 +/- 7.4 mg/L), levels did not correlate with the presence of AF or with eGFR. Finally, eGFR did not correlate with the presence of AF in our population.
The prevalence of AF was increased in our population, and independent predictors were age, white race, increasing left atrial diameter, lower systolic BP, and congestive heart failure.
慢性肾脏病（CKD）会引起全身炎症，这与房颤（AF）的发生和维持有关；因此，我们假设非透析 CKD 患者的 AF 患病率会增加。本研究还报告了该人群中 AF 存在的独立预测因素。
设计、设置、参与者和测量：对来自两家社区医院的 1010 例连续非透析 CKD 患者进行回顾性、横断面分析。使用肾脏病饮食改良公式（MDRD）计算估计肾小球滤过率（eGFR）。使用多变量逻辑回归确定独立预测因素。
在 1010 例非透析 CKD 患者中，有 214 例（21.2%）患有 AF。患有 AF 的患者比没有 AF 的患者年龄更大（76 +/- 11 岁 vs 63 +/- 15 岁）。白人患者（42.7%）的 AF 患病率高于黑人患者（12.7%）或其他种族患者（5.7%）。多变量分析表明，年龄、白种人、左心房直径增大、收缩压降低和充血性心力衰竭是 AF 存在的独立预测因素。尽管我们人群中的血清高敏 C 反应蛋白水平升高（5.2 +/- 7.4 mg/L），但水平与 AF 的存在或 eGFR 均无相关性。最后，在我们的人群中，eGFR 与 AF 的存在无关。
在我们的人群中，AF 的患病率增加，独立预测因素为年龄、白种人、左心房直径增大、收缩压降低和充血性心力衰竭。
