Kidney Center, Turku University Hospital and University of Turku, Turku, Finland,
Kidney Center, Turku University Hospital and University of Turku, Turku, Finland.
Nephron. 2021;145(1):71-77. doi: 10.1159/000511451. Epub 2020 Dec 2.
Atrial fibrillation (AF) and CKD are commonly coexisting conditions. However, data on epidemiology of AF in patients with CKD stage 4-5 is scarce.
We prospectively enrolled 210 consecutive non-dialysis patients with CKD stage 4-5 between 2013 and 2017. Follow-up data on AF incidence along with medical history, laboratory tests, and echocardiography at baseline were gathered.
At baseline, mean age was 62 years, estimated glomerular filtration rate 12.8 mL/min, and 73/210 (34.8%) participants were female. Altogether, 41/210 (19.5%) patients had a previous diagnosis of AF. After median follow-up of 46 [IQR 27] months, new-onset AF occurred in 33/169 (19.5%) patients (69.9 events/1,000 person-years). In the Cox proportional hazard model, age >60 years (HR 4.27, CI 95% 1.57-11.64, p < 0.01), elevated troponin T (TnT) >50 ng/L (HR 3.61, CI 95% 1.55-8.37, p < 0.01), and left atrial volume index (LAVI) >30 mL/m2 (HR 4.82, CI 95% 1.11-21.00, p = 0.04) were independently associated with the incidence of new-onset AF.
The prevalence and incidence of AF was markedly high in this prospective study on patients with CKD stage 4-5. Elevated TnT and increased LAVI were independently associated with the occurrence of new-onset AF in patients with severe CKD.
心房颤动（AF）和慢性肾脏病（CKD）通常同时存在。然而，关于 CKD 4-5 期患者中 AF 的流行病学数据很少。
我们前瞻性纳入了 2013 年至 2017 年间 210 例连续非透析 CKD 4-5 期患者。收集了 AF 发生率的随访数据以及基线时的病史、实验室检查和超声心动图。
基线时，平均年龄为 62 岁，估计肾小球滤过率为 12.8 mL/min，210 例患者中有 73/210（34.8%）为女性。共有 41/210（19.5%）患者既往有 AF 诊断。中位随访 46[IQR 27]个月后，169 例患者中有 33 例（69.9 例/1000 人年）发生新发 AF。在 Cox 比例风险模型中，年龄>60 岁（HR 4.27，95%CI 1.57-11.64，p<0.01）、高敏肌钙蛋白 T（TnT）>50ng/L（HR 3.61，95%CI 1.55-8.37，p<0.01）和左心房容积指数（LAVI）>30mL/m2（HR 4.82，95%CI 1.11-21.00，p=0.04）与新发 AF 的发生独立相关。
在这项前瞻性研究中，CKD 4-5 期患者的 AF 患病率和发生率明显较高。高敏肌钙蛋白 T 和左心房容积指数增加与严重 CKD 患者新发 AF 的发生独立相关。
