Zena and Michael A. Wiener Cardiovascular Institute and Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai School of Medicine, New York, NY, USA.
Circ Arrhythm Electrophysiol. 2011 Feb;4(1):26-32. doi: 10.1161/CIRCEP.110.957100. Epub 2010 Nov 13.
Atrial fibrillation (AF) is common among patients with end-stage renal disease, but few data are available on its prevalence among adults with chronic kidney disease (CKD) of lesser severity. methods and results: We evaluated the association of CKD with ECG-detected AF among 26 917 participants in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, a population-based cohort of African-American and white US adults ≥45 years of age. Estimated glomerular filtration rate (eGFR) was calculated using the abbreviated Modification of Diet in Renal Disease study equation and albuminuria was defined as a urinary albumin to creatinine ratio ≥30 mg/g. Participants were categorized by renal function: no CKD (eGFR ≥60 mL/min/1.73 m(2) without albuminuria, n=21 081), stage 1 to 2 CKD (eGFR ≥60 mL/min/1.73 m(2) with albuminuria n=2938), stage 3 CKD (eGFR 30 to 59 mL/min/1.73 m(2), n=2683) and stage 4 to 5 CKD (eGFR <30 mL/min/1.73 m(2), n=215). The prevalence of AF among participants without CKD, and with stage 1 to 2, stage 3, and stage 4 to 5 CKD was 1.0%, 2.8%, 2.7% and 4.2%, respectively. Compared with participants without CKD, the age-, race-, and sex-adjusted odds ratios for prevalent AF were 2.67 (95% confidence interval, 2.04 to 3.48), 1.68 (95% confidence interval, 1.26 to 2.24) and 3.52 (95% confidence interval, 1.73 to 7.15) among those with stage 1 to 2, stage 3, and stage 4 to 5 CKD. The association between CKD and prevalent AF remained statistically significant after further multivariable adjustment and was consistent across numerous subgroups.
Regardless of severity, CKD is associated with an increased prevalence of AF among US adults.
心房颤动（AF）在终末期肾病患者中很常见，但在慢性肾脏病（CKD）程度较轻的成人中，其患病率的数据很少。
我们评估了 CKD 与 26917 名参加原因地理和种族差异中风（REGARDS）研究的参与者中的心电图检测到的 AF 之间的关联，这是一项基于人群的非洲裔美国人和白人美国成年人≥45 岁的队列研究。使用简化肾脏病饮食研究方程估算肾小球滤过率（eGFR），并将白蛋白尿定义为尿白蛋白与肌酐比值≥30mg/g。参与者按肾功能分类：无 CKD（eGFR≥60mL/min/1.73m²，无白蛋白尿，n=21081）、1 至 2 期 CKD（eGFR≥60mL/min/1.73m²，白蛋白尿 n=2938）、3 期 CKD（eGFR 30 至 59mL/min/1.73m²，n=2683）和 4 至 5 期 CKD（eGFR<30mL/min/1.73m²，n=215）。无 CKD 参与者、1 至 2 期、3 期和 4 至 5 期 CKD 患者中 AF 的患病率分别为 1.0%、2.8%、2.7%和 4.2%。与无 CKD 的参与者相比，1 至 2 期、3 期和 4 至 5 期 CKD 患者中 AF 的调整后比值比（95%置信区间）分别为 2.67（2.04 至 3.48）、1.68（1.26 至 2.24）和 3.52（1.73 至 7.15）。在进一步的多变量调整后，CKD 与 AF 患病率之间的关联仍然具有统计学意义，并且在众多亚组中一致。
无论严重程度如何，CKD 与美国成年人 AF 患病率增加有关。
