Laukkanen Jari A, Zaccardi Francesco, Karppi Jouni, Ronkainen Kimmo, Kurl Sudhir
University of Eastern Finland, Department of Medicine, Institute of Public Health and Clinical Nutrition, Kuopio, Finland.
Internal Medicine and Diabetes Care Unit, Catholic University, Rome, Italy.
Nephrology (Carlton). 2016 Aug;21(8):717-20. doi: 10.1111/nep.12727.
There is limited knowledge on the relationship between kidney function and incidence of atrial fibrillation. Thus, this prospective study was designed to evaluate whether various biomarkers of kidney function are associated to the risk of atrial fibrillation. The study population consisted of 1840 subjects (615 women and 1225 men) aged 61-82 years. Cystatin C- and creatinine-based estimation of glomerular filtration rate (eGFRcys and eGRFcreat , respectively) and urinary albumin/creatinine ratio (ACR) were assessed to investigate their relationship with the risk of atrial fibrillation. During a median follow-up of 3.7 years, a total of 159 incident atrial fibrillation cases occurred. After adjustment for potential confounders, the risk of atrial fibrillation was increased (hazard ratio 2.74, 95% confidence interval (CI) 1.56-4.81, P < 0.001) in subjects with reduced kidney function (eGFRcys , 15-59 mL/min per 1.73 m(2) ) compared to subjects with normal kidney function (≥90 mL/min per 1.73 m(2) ). Similar results were also found when comparing the respective groups of subjects defined by their eGRFcreat levels (hazard ratio 2.41, CI 1.09-5.30, P = 0.029). Consistently, subjects with ACR ≥300 mg/g had an increased risk of incident atrial fibrillation (hazard ratio 2.16, CI 1.35-2.82, P < 0.001) compared to those with ACR <30 mg/g. Reduced eGFR and albuminuria were associated with an increased risk of atrial fibrillation.
关于肾功能与心房颤动发病率之间的关系，目前所知有限。因此，本前瞻性研究旨在评估各种肾功能生物标志物是否与心房颤动风险相关。研究人群包括1840名年龄在61 - 82岁之间的受试者（615名女性和1225名男性）。评估了基于胱抑素C和肌酐的肾小球滤过率估计值（分别为eGFRcys和eGRFcreat）以及尿白蛋白/肌酐比值（ACR），以研究它们与心房颤动风险的关系。在中位随访3.7年期间，共发生159例新发心房颤动病例。在对潜在混杂因素进行调整后，与肾功能正常（≥90 mL/min per 1.73 m²）的受试者相比，肾功能降低（eGFRcys，15 - 59 mL/min per 1.73 m²）的受试者发生心房颤动的风险增加（风险比2.74，95%置信区间（CI）1.56 - 4.81，P < 0.001）。当比较根据eGRFcreat水平定义的各受试者组时，也发现了类似结果（风险比2.41，CI 1.09 - 5.30，P = 0.029）。同样，与ACR < 30 mg/g的受试者相比，ACR≥300 mg/g的受试者发生新发心房颤动的风险增加（风险比2.16，CI 1.35 - 2.82，P < 0.001）。肾小球滤过率降低和蛋白尿与心房颤动风险增加相关。
