Suwanwongse Kulachanya, Shabarek Nehad
Internal Medicine, Lincoln Medical Center, New York City, USA.
Cureus. 2020 Feb 7;12(2):e6908. doi: 10.7759/cureus.6908.
Patients with atrial fibrillation (AF) have elevated risks of developing stroke, heart failure, and myocardial infarction. However, the impact of AF on the progression of chronic kidney disease (CKD) is uncertain. Our review objective is to investigate whether AF increases the risk of developing end-stage renal disease (ESRD) in patients with CKD. On 31 January 2019, a systemic search was performed on the MEDLINE database using the predefined search criteria. Limits included human participants and English-language publications. Studies that evaluated an association of AF and the risk of CKD progression to ESRD were selected. A total of 751 articles were identified. One prospective cohort study was included after screening abstracts from overall retrieved studies based on our inclusion/exclusion criteria, with a total of 3,091 CKD patients and a mean follow-up of 5.9 years. A total of 172 CKD patients developed AF, of which 43 patients later developed ESRD. Of 2,919 CKD patients with no incident AF, 581 patients progressed to ESRD. The rate of ESRD after the development of AF was 11.8/100 person-years compared with 3.4/100 person-years in CKD patients without AF. In conclusion, AF is an independent risk factor for developing ESRD in CKD patients, but more evidence is needed to support this result.
心房颤动（AF）患者发生中风、心力衰竭和心肌梗死的风险升高。然而，AF对慢性肾脏病（CKD）进展的影响尚不确定。我们的综述目的是调查AF是否会增加CKD患者发生终末期肾病（ESRD）的风险。2019年1月31日，使用预定义的搜索标准对MEDLINE数据库进行了系统检索。限制条件包括人类参与者和英文出版物。选择评估AF与CKD进展至ESRD风险之间关联的研究。共识别出751篇文章。根据纳入/排除标准从所有检索到的研究中筛选摘要后，纳入了一项前瞻性队列研究，共有3091例CKD患者，平均随访5.9年。共有l72例CKD患者发生AF，其中43例患者后来发展为ESRD。在2919例无AF事件的CKD患者中，581例进展为ESRD。AF发生后ESRD的发生率为11.8/100人年，而无AF的CKD患者为3.4/100人年。总之，AF是CKD患者发生ESRD的独立危险因素，但需要更多证据支持这一结果。
